Egyptian dental journal (Egypt Dent J)

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ISSN 0070-9484

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    ABSTRACT: Bone morphogenetic protein-2 is a potent inducer of de novo bone generation. Large scalestudies using this technique and material had never been ventured in maxillary clefts. This prospective study aims to compare the grafting outcome of rhBMP-2in unilateral cleft lip and palate (UCLP) patients and the iliac crest graft treated cases, as evident by the eruption pattern of the cleft side permanent maxillary canine. Subject and Methods: A total of 16 patients with unilateral cleft lip and palate, with average age 10.5 years were selected and randomly allocated to two groups. Group A (n=8) received BMP-2 and Group B (n=8) underwent iliac traditional crest bone grafting of the alveolar cleft defect. A third control group was selected from the contralateral canines on the non-cleft side of the same patient Group C. Cone beam computed tomography scans before grafting and 11/2 years post-grafting were obtained. The data obtained from the CBCT scanning were imported into the OnDemand 3D software for secondary reconstruction and performing the measurements. The direction of movement of the canine, both in facio-palatal and mesio-distal direction was determined. The width of the alveolar cleft was measured clinically and radiographically. Results: Canines on the side grafted with BMP (Gp A)erupted in a distal direction, while those on the IC side (Gp B) erupted mesially. On the non-cleft side, Gp (C), canines moved mesially and facially. A negative non-significant correlation was found between the width of the cleft grafted with BMP-2 and direction of canine movement. Conclusions: Sparing children from the procedure of iliac crest harvesting is by itself a compelling reason to favour rhBMP2 use. Canines were able to erupt satisfactory in all patients grafted withBMP-2 without the risk of impaction. However, the indications and optimal timing for Grafting with BMP-2 should be based on factors such as cleft width. Further studies with larger sample size to comprehensively assess the outcome are advised
    Egyptian dental journal 07/2014; 60(july):3053-3060.
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    ABSTRACT: Mucogingival surgical operations are designed to provide a functionally adequate zone of keratinized attached gingiva. Although these surgical operations are not specifically designed for pocket elimination, these procedure s can be combined with other operations in an attempt to obtain overall healthy periodontal situation. By definition, mucogingival surgery consists of plastic surgical techniques directed toward the correction of gingivo-mucosal membrane relationships that complicate periodontal disease and may interfere with the success of overall periodontal therapy.
    Egyptian dental journal 04/2014; 60(2):2307-2315.
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    ABSTRACT: Aim: The purpose of the present study was to analyze surface characteristics of Twisted File (TF) Ni-Ti rotary instrument before use and to investigate the effect of instrumentation, irrigation using sodium hypochlorite (NaOCl) and sterilization on surface topography and the elemental composition. Materials and methods: A total of 20 new TF Ni-Ti rotary instruments with size 25 and 6% taper were divided into five groups, five instruments/group Group I, as received files. Group II, files used in preparation of twenty curved mesio-buccal canals (20˚-40˚) in presence of NaOCl. Group III, the five used files in group II were further subjected to a single cycle of steam autoclave sterilization at 121 °C, 15 psi for 30 minutes. Group IV, as received files in contact with 5.25% NaOCl for 15 minutes. Group V, as received files subjected to sterilization, similar to group III. Each instrument was screened from the tip along the working part using the SEM equipped with energy dispersive x-ray microanalysis EDX Unit and representative photomicrographs were taken at a magnification of 500X (surface) and 1000X (blade). The following criteria were recorded: I: Defects: A-On surface(seven): (1) Irregular metal strips (2) Regular metal strips (3) Pitting (4) Crater (5) Machine striations (6) Ballooning along the striations(7) Scrapes. B- On blade edge (Four): (1) Roll-over (2) Pits (3) Notches (4) Localized metal flake. II: Debris. Chi-square (x2) compared percentage of each criterion along the five groups. One-way ANOVA compared mean of sum of all criteria/group or those on surface/group or blade edge/group among the five groups. Significance level was at P ≤ 0.05. Results: There was a statistically significant difference between five groups regarding total number of defects/group (P-value < 0.001), surface defects/group (P-value = 0.001) and blade edge defects/group (P-value = 0.003). Used files in groups II, III had highest mean of total, surface and blade defects (II>III with no significant difference). Eight defects existed at 100%. Unused files in groups IV: NaOCl, V: Sterilization had intermediate mean of total and blade defects and lowest mean of surface defects, (V>IV with no significant difference). Six defects existed in range of 80-100%. Group I had lowest mean of total and blade defects and intermediate mean of surface defects. Three defects existed in 100%. Debris showed 100% prevalence in group I and group IV. EDX of Group I showed: Ni (42%), Ti (33%), Al (11%),C (12%), O (7%), Group II, Ni (49%), Ti (41%), Group III: Ni(50.5%), Ti (41%),Al (8.5%). Group IV: Ni (50%), Ti (42%), Al (8.1%), and Group V: Ni (49%), Ti (41%), Al (8%). Conclusions: 1-Combined mechanical instrumentation and chemical usage of NaOCl with and without subsequent sterilization affected surface topography and elemental composition of rotary Nickel Titanium Twisted Files. 2- Precise manufacturing quality control of as-received Twisted Files instruments is still recommended.
    Egyptian dental journal 01/2014; 60(January):187-199.
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    ABSTRACT: Aim of this study: to evaluate the efficacyof Multislice computed tomography in diagnosis and evaluation of treatment outcome of oro-antralfistula (OAF) Materials and Methods: A total of ten patients (8 males and 2 females), with age ranged from 19 to 51 years were included in the study. The diagnosis was confirmedby the history of signs and symptoms of OAF. Preoperative multislice CT scans were performed for all patients. The developed chronic sinusitis was treated at firstin all cases by surgical removal of the pathological tract . For two weeks; antibiotic and non-steroidal anti-inflammatoryas well adult nasal drops were described. Then all fistulaewere treated surgically using palatal rotational flapafter resolution of all signs and symptoms of developed sinusitis. This was confirmedby multislice CT scan. Follow-up evaluations were performed using also multislice CT cuts at immediate postoperative, 3 and 6 months . Results: Preoperative multislice images showed discontinuity of the bony floorof the antrum with communication between the oral cavities in all patients. The margins of fistulaewere irregular. Opacificationof the ipsilateral sinuses were seen in all cases of the study (100%). In four of ten patients (40%), the multislice CT scanning represented opacificationin their contralateral sinuses two of them with increased thickness of sinus’ membrane and all of them had history of chronic sinusitis. The radiographic fistulassize ranged from 9mm to 14mm. The presurgical radiographs demonstrated that ipsilateral sinuses became devoid of opacities and appeared clear in all cases after two weeks period of sinus irrigation. Immediately postoperative scans illustrated that the recurrence of opacificationin the sinus in all patients with increased thickness of sinus’ membrane. At three month postoperatively, the images showed that the opacificationdecreased gradually and there was slight thickening of the Schneiderian membrane. While at six months, the radiolucency of the maxillary sinuses was symmetrical on both sides. The sinus membrane appeared intact and the radiographic findings of sinusitis and clinical symptoms disappeared in all cases Conclusion: Multislice CT scan allows adequate visualization of OAF especially small defects. It is relatively non-invasive and provides detailed information for surgical planning to close fistula. Also, CT images allows precise display of ipsilateral sinus.
    Egyptian dental journal 01/2014;
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    ABSTRACT: This study was carried out to investigate the effect of Er:Yag laser ablation on the bonding efficacy of ceramic blocks to enamel and dentin using contemporary resin cements. Flattened enamel and dentin surfaces of 28 anterior and posterior teeth were exposed. Half of the exposed teeth surfaces were prepared using high speed cylindrical carbide bur while the second half of the teeth surfaces were prepared with an Er:YAG laser (Fidelis, Fotona Medical Lasers). Standardized 3 mm thickness ceramic slabs were luted to prepared enamel and dentin surfaces using either (RelyX ARC, 3M/ESPE) after pretreatment with two steps etch-and-rinse adhesive (Adper Single Bond Plus, 3M ESPE) or the direct use of self-adhesive cement (RelyX Unicem Maxicap, 3M/ESPE). After 24 hours storage, teeth were sectioned and micro-tensile bond strength (μTBS) was detected. It was found that the mean μTBS values of bur-prepared enamel restored with etch-and-rinse and self-adhesive systems were (23.6±4.1MPa) and (15.1±3.1 MPa), respectively. In addition, the mean μTBS values of laser-ablated enamel restored with etch-and-rinse and self-adhesive systems were (24.1MPa±2) and (19.1±4.8 MPa), respectively. On the other hand, the mean μTBS values using etch-and-rinse system were (20.6±3.3 MPa) and (17.5±3.4 MPa) to bur-prepared and laser-ablated dentin, respectively. Moreover, when the self adhesive system was used, the recorded mean μTBS values were (9.1±2.9 MPa) and (15.9±1.8 MPa) with bur-prepared and laser-ablated dentin, respectively.
    Egyptian dental journal 07/2013; 59(3):3165-3175.
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    ABSTRACT: Study of clinicopathological features of malignant tumors in different population is of a considerable importance in the understanding of etiological factors and different modalities of treatments. In Saudi Arabia, there is a lack of nation-wide epidemiological studies characterizing oral malignancies. Objective: To describe the demographic, clinical and histopathological pattern of the oral cancer cases obtained from the archives of College of Dentistry-King Saud University. Methodology: Data were collected from the histopathology laboratory archives of College of Dentistry, King Saud University over a period of 21 years (from 1989 to 2010) in regard to clinical and histopathological data. Data were recorded and statistically analyzed. Results: Sixty cases of oral squamous cell carcinoma were reported, representing 1.85% of a total of 3,233 cases accessioned. The mean age was (50 years) with 1.6:1 male to female ratio. The tongue represented 30% of the cases. Alveolus and gingiva (24.3%) buccal mucosa (22.9%) followed by floor of the mouth (14.3%). More than half of the cases(62%) were histopathologically diagnosed as well differentiated subtype of squamous cell carcinoma. Conclusion: Collecting a detailed and accurate clinicopathological data of oral cancer patients over the years may help in mapping the incidence with the possible causative agents which may shed a light on the different ways of prevention and early detection leading to a better prognosis and improving the quality of life of such patients.
    Egyptian dental journal 04/2013; 59(2):1257.
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    ABSTRACT: Objectives: the purpose of the present study was to assess the contemporary practice of cross infection control of dental impressions in governmental & private dental labs & prosthodontic clinics of MoH, Al-Qassim, KSA, assessing how dentists are communicating with lab personnel about impression disinfection, and lastly detecting awareness about infection control practices in dental laboratories. Materials and Methods: A cross-sectional study including pre-prepared self-administered questionnaires. The study sample included 46 dental technicians & 48 dentists in two cities: Buraidah & Unaizah. The technicians and the prosthodontists were exposed to questionnaires consisting of 26 and 14 questions, respectively. The questions were administered to each of the dental technicians and dentists in the dental laboratory& clinics. A thorough description of the study circumstances was made alongside with stress on the privacy of the questionnaire. The returned questionnaires were revised for comprehensiveness. Results: About 63.00% of the technicians recognized that the impressions have been disinfected and 58.33% of the dentists informed their technicians that the impressions have already been disinfected. More than 67.00% of the technicians reported that there is an agreed protocol between the lab and the dental office, and 44.44% of the prosthodontists stated that they notify the technicians through notes on the impression bags. Liquid disinfectant immersion constituted the highest product or technique used by prosthodontists (39.13%). More than 84.00% and 78.26% of the technicians registered that they disinfect alginate as well as rubber base impressions, respectively, by themselves, and ten minutes was the duration mostly accepted for both impression materials. About 63.00% of the studied group reported that all technicians in the lab were vaccinated for hepatitis B virus (HBV). The majority of dental technicians revealed that they apply infection control measures in the dental lab concerning disinfection of laboratory work surfaces and the hand instruments. For the precautions they take when receiving the impressions or any work delivered from the clinic only 8.70% of the technicians reported that they apply all precautions.Fifty percent of the prosthodontists stated that they are not sure that the technicians disinfect the impressions before pouring. About 65.00% of the technicians stated that they feel that dental laboratories are adequately instructed for disinfection techniques of different impression materials and on the contrary, 66.67% of the prosthodontists didn’t feel that.Conclusion:There is moderate communication between dental laboratory technicians and prosthodontists. Liquid disinfectant immersion comprised the highest product or technique used by the prosthodontists for proper disinfection of impressions and the procedure performed for ten minutes. The majority of dental technicians were vaccinated for HBV. Lack of communication between the prosthodontists and their dental technicians was noticeable as the dentists are not sure whether the technicians disinfect the preliminary/working impressions before pouring. A significant nonconformity of view between the dental technicians and prosthodontics with regard to adequate instructions for the dental laboratories for different impression materials was reported.
    Egyptian dental journal 01/2013; 59(5):2703.