mohammad alsehimy

Objectives: The objective of this study was to evaluate the effectiveness of a nonsurgical treatment regimen in the long-term control of necrotic areas of the jaws and pain in such patients.
Methods: A total of 96 patients suffering from the disease were included in this study. All patients received nonsurgical treatment regimen for 10 days, and repeated every 3 months for 2 years. The size of the osteonecrotic lesions was measured and the pain level was self-assessed with a visual analog scale.
Results: The patients showed a statistically significant (F = 16.1; p < .01; r2 = .95) gradual decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 to 8.8 mm). Pain scores ranged from 0 to 3 score scale. Complete resolution of the disease was observed in some patients.
Conclusions: This conservative nonsurgical treatment regimen seems to provide successful treatment in reduction of the sizes of exposed bone areas in the majority of patients.

Background : In the process of placing an oseointegrated implant into the resorbed maxillary posterior region, there is often a need for sinus floor elevation. Usually the maxillary sinus pneumatizes toward the ridge crest after dental extraction. Thus, there is a consequent decrease in the available bone height, disfavoring prognosis and preventing implant placement. Aims or Objectives : The objective of the present study was to evaluate and compare two different techniques for sinus floor elevation along with setting oseointegrated implants.
Methods : Twelve patients, 35-45 years old, ten males and two females underwent implant rehabilitation in the maxillary premolar/molar region. Half of the patients were managed by the modified Summers’ osteotome technique , and the remainder by the SINUS UP technique.
Results : Each technique showed advantages and disadvantages.
Conclusions : 1.The osteotome technique was found to be suitable for elevating the antral membrane when an average increase of 3 to 4 mm bone was needed, and at least 4 mm remaining. Its high success rate shows an image of long term bone formation. 2.Where ridge resorption is more advanced and at least 4 mm is remaining, a lateral antrostomy is required in order to end up with sufficient bone height for adequate implant length. 3.The different sinus elevation techniques did not seem to affect the implant success rate. Using β-TCP in the strip form opens up new possibilities for sinus lift procedures, since it simplifies this surgical technique.

ABSTRACT :
There is a paucity of recent data regarding osteomyelitis of the jaws (OMJ) particularly in Saudi population . Patients with inflammation of the jaw attended King Abdulaziz University Hospital , Faculty of dentistry oral surgery clinics and many medical centers in , Jeddah , KSA from Jan. 1990 - Dec. 2010 underwent retrospective chart review with regard of OMJ to assess the encountered risk factors . Forty-two patients , out of one thousand charted in such period , met the criteria for OMJ (37 definite, 5 probable). Mean age was 58 years. Most common risk factors associated with OMJ were tooth extraction, orofacial malignancy and radiotherapy. Most common symptoms were pain, exposed bone/plate and cheek swelling. Aerobic (GP 84%, GN 42%) and anaerobic (GP 53%, GN 27%) bacteria were identified. Thirty four % of patients received > 4 weeks of IV antibiotics. Five patients achieved full recovery. Limited recovery was associated with orofacial malignancy and radiotherapy ( p = 0.06 ). Radiotherapy for orofacial malignancy has emerged as major risk factor associated with OMJ. Only orofacial malignancy and radiotherapy predicted limited recovery. Length of antibiotic therapy or hyperbaric oxygen therapy (HBOT) did not predict treatment outcome. ( DSR grant no.462 / 165 / 1431) .

ABSTRACT : .
Idiopathic Bell`s palsy is a weakness or complete paralysis of facial muscles . On the other hand , it is a peripheral facial paralysis believed to be the result of edema and compression of the facial nerve at the meatal foramen inside the temporal canal in the temporal bone . More recently , it was shown that Bell`s palsy may be due to reactivated herpes simplex virus . Therefore , an agent like acyclovir which is effective against this virus seems logic to treat this condition . A study was undertaken to assess and compare the different modalities of treatment of early Bell`s palsy ; such as acupuncture , acyclovir , prednisolone , faradic stimulation , facial exercise , and short wave therapy . It was found that a combination of acupuncture and the common type of treatments is superior to other treatment modalities . Patients responded to acyclovir indicated that infection with herpes simplex virus is the most likely cause of Bell`s palsy .

ABSTRACT :
Several retrospective studies demonstrated that TMJ implants seemed to accelerate joint destruction as proved by FDA in 1990 . So , the current study was performed in an attempt to investigate the basic response of the tissue to failed TMJ proplast-teflon interpositional implants ( PTIPI ) . Thirteen patients underwent meniscectomy and disc replacement with Proplast-Teflon implants , and suffering from post-surgery pain , limited mouth opening , and joint noises that necessitated removal of the implants , were used for this study . It was shown that the PTIPI – induced lesions characteristically exhibited a large number of macrophages in the stroma of collagen – rich connective tissue . Animal experiments have shown also that PTIPI has the potential to induce destructive bony changes in operated joints based on reactive synovitis and massive infiltration of foreign body giant cells . Thus , it may be suggested that PTIPI is responsible for the destructive effect . However , mechanical stress seems important in the fragmentation of the implant and induction of the foreign body reaction too.

ABSTRACT :
Patients with chronic TMJ disorders associated with disc displacement without perforation were collected . Preoperative MRI findings , pathologic findings , and surgical findings were correlated to each other . MRI was found to be a reliable noninvasive procedure that clearly demonstrates TMJ structures . It is effective in revealing disc displacement .

ABSTRACT :
Bone grafting of the cleft maxilla and palate has caused considerable controversy and discussion .Too often clefts of the palate treated by conventional methods lead to collapse of the lesser segment of the maxilla and limit the potential of orthodontic treatment .Effects of early bone grafting on facial skeletal growth in patients with cleft lip and palate . It was shown that there were no unwarranted growth restrains compared with a similar series having no clefts .It was clear that early maxillary orthodontia and primary osteoplasty , done with care and in a planned sequence with lip and palate closure , has several advantages .

ABSTRACT :
In 1990 , the FDA advised oral and maxillofacial surgeons against the use of proplast-coated TMJ implants . It , further , requested that all unused implants be returned to the company . This was followed , in 1991 , by the advisory with the directive that patients with proplast-coated implants should be annually evaluated clinically and radiographically . If there is evidence of progressive implant changes , the implants should be removed . Hence , this clinical study presented the management of failure of some alloplastic TMJ implants . Thirteen patients with failed proplast-coated disc implants were collected . The alloplastic implants were removed , and a temporalis muscle flap was rotated and inserted instead . Patients were observed for a period of 6-12 months . It was found that placement of temporalis muscle and fascia flap is effective in the management of failed implants .

ABSTRACT :
Numerous bone grafting techniques with and without immediate implant placement have been advocated . A maxillary one stage antral and nasal lift techniques combined with free autogenous corticocancellous iliac bone grafts secured by endosseous titanium implants were performed to nine patients suffering from compromised maxilla , with great survival and success rates .

ABSTRACT :
Segmental continuity defects of the mandible may occur after trauma , infection or tumor resection surgery . Therefore , it was thought desirable to evaluate and compare the long-term results of the endosseous implants placed into grafted vascularized and nonvascularized bone for the reconstruction of anterior segmental defects of the mandible . Some patients underwent primary reconstruction by nonvascularized bone autografts , and the other patients by vascularized ones . All grafts were taken from the iliac crest of the same patients . Most grafts were further stabilized by means of endosseous titanium implants . It was found that primary mandibular reconstruction with vascularized or nonvascularized autogenous bone grafts supported by implants is a predictable treatment for mandibular continuity defects .

A new lesion of concern with startling clinical appearance . It is characterized mainly by punched out , sharply demarcated , craterous ulcer . The ulcer is almost covered with necrotic tissue and is not painful , bearing a very strong resemblance to squamous cell carcinoma . Histologically , the lesion mimic also carcinoma . However , the lesion is benign and self-healing . Healing is generally slow , requiring up to 8 weeks for complete resolution .

ABSTRACT :
A new technique for closure of chronic oro-antral fistula is described . In this technique , the fistulous tract is everted towards the oral cavity through the opening of the fistula . Then , instead it is incised and removed as usual , it is sutured with the surrounding mucoperiostium. It is a relatively simple procedure , neither a graft nor an alloplastic material or others is needed . This technique proved effective in closing all cases .

ABSTRACT:
The cardiac function in a sample of cardiovascular patients was investigated by echocardiography during dental treatment using local anaesthesia . The anaesthetic used was 2% lidocaine with 1 : 100 , 000 epinephrine , which is now considered by many authors as a safe concentration . It was found at the end of the study that the cardiac output , stroke volume , heart rate , ejection fraction as well as other parameters were , unexpectedly , enhanced and increased in cardiovascular patients . These parameters were not changed in normal healthy patients . It was concluded , hence , that lidocaine 2% with adrenaline 1 : 100,000 should be used with causion in cardiovascular diseased patients .

ABSTRACT :
Swelling and pain were assessed in 16 patients with bilaterally impacted mandibular third molar , oerated upon under fluothane general anaesthesia . Local anaesthesia was an adjuvant in the right side operations while the left side acted as control , injected with normal saline . Patients were easily maintainted at a lower level of fluothane concentration while operating on their right sides compared to the left . Results stressed the important role of local anaesthesia in minimizing postoperative pain and swelling .

ABSTRACT :
Five hundred patients suffering from acute temporomandibular joint arthralgia were entered into a double blind randomized study in an attempt to compare between the efficacy of certain new drugs in the treatment of acute TMJ arthralgia . Patients were divided into 5 groups ; 100 patients each . Nabumetone , indomethacin , azapropazone , tapride or placebo were administered to the patients for 6 weeks . Joint pain disappeared completely in the majority of patients with much improvement in patients taking tiapride . One year follow-up showed no prompt recurrence of pain in the TMJ region .

ABSTRACT :
Though relatively infrequent , animal bites in the head and neck region can produce potentially serious pathologic conditions that must be judiciously addressed . Facial wound caused by animal attack require proper wound management . Moreover , the evaluation and treatment plan of facial wounds must always include the possibility of rabies . BECAUSE OF ITS INFREQUENT OCCURRENCE IN HUMANS , MANY CLINICIANS may not be cognizant of the current antirabies prophylaxis . So , this study was undertaken to elucidate a recommended protocol for rabies control and the treatment of associated bites and scratch wounds .

ABSTRACT :
Twenty-five human volunteers were used in this study to examine the systemic effects following periodontal ligament injection ( PDL ) using a citoject high pressure syringe ( Bayer , Leverkusen , W. Germany ) . A parallel study was carried out on 5 dogs . The hypothysis that pressure created during intraligamental injection is the causative factor in attaining anaesthesia was tested and evaluated . The results of this study indicated that PDL injection leads to extremely rapid absorption of injected solutions and that epinephrine may cause rapid but transient periods of hypotension and tachycardia that are clinically significant . It was also shown that PDL anaesthesia was not due to intraligamental pressure per se but due to the effect of the anaesthetic agent on sensory nerves .

ABSTRACT :
One hundred patients suffering from acute orofacial cellulitis were used in this study to investigate the value of systemic antihistaminics in the treatment of acute oral infection . The results of this study indicated that systemic antihistaminic is a valuable adjunctive to conventional antibiotics in the treatment of acute orofacial flare-ups . Thus , systemic antihistaminic could be considered as a principal treatment for oral infection .

ABSTRACT :
A total of 200 male outpatients with postextraction alveolitis were used for this study . One hundred patients were treated with solcoseryl dental adhesive paste ( SSDAP ) and the other patients received Apernyl in their extraction sockets , in order to compare between both preparations in the treatment of postextraction alveolitis .It was found that pain was relieved very rapidly and wounds healed very faster with SSDAP than with Apernyl . It may be stated that , on the basis of its composition and on its convincing efficacy , that SSDAP represents a radically new way of treating postextraction alveolitis compared with other methods of therapy .

ABSTRACT :
The incidence of localized osteitis after extraction in patients under oral contraceptive Pills was studied . Three common types used by Egyptian women ; namely Ovulen , Ovral , and Microvlar were evaluated and the incidence of localized osteitis after extraction was considered . The overall incidence of localized osteitis in these patients was found to be 22.85 % . However , it is 2.85 % in normal women . It was found also that great incidence of localized osteitis occurred in women taking ovulen tablets ( 31.42 % ) , followed by ovral ( 22.85 % ) and microvlar ( 14.28 % ) , respectively . Finally , it was concluded that Microvlar is a reasonable drug in eliciting localized osteitis in Egyptian women using oral contraceptive Pills .