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The aim of the current study was to evaluate efficacy of using iliac grafts combined with implants and retaining a provisional fixed-detachable (hybrid) prosthesis in the reconstruction of mandibular defects regarding average bone loss in graft height, peri-implant marginal bone loss, maximum bite force, facial asymmetry ,patient satisfaction and oral health quality of life (OHRQoL). Patients and methods: 11 patients were subjected to mandibular marginal resection with immediate reconstruction by autogenous iliac crest graft with implant placement. After 6 months they were rehabilitated with provisional screw-retained prosthesis. Radiographic assessment of average bone loss in graft height and marginal bone loss around dental implants was performed. Facial asymmetry, Maximum bite force, Patient satisfaction and oral health quality of life (OHRQoL) were assessed after the first surgery, at loading, 6 and 12 months later. Results: Average bone loss of graft height (mean 2.14±1.03). Average peri-implant Marginal bone loss after 1 year 1.42±0.38. The increase in marginal bone loss along the study period was significant (P<0.001). Maximum bite force of the rehabilitated side increased significantly along the study period. There was a statistically high significant difference between the scores of all OHIP-5 items scores except in the scores of the difficulty doing usual jobs item. Conclusion: Within the limitations of this study, it was concluded that construction of mandibular defect using iliac crest graft combined with dental implants and retaining a provisional fixed-detachable prothesis can be an effective procedure to restore bony defect, facial asymmetry, maximum bite force, patient satisfaction and oral health quality of life.

The pathogenesis of odontogenic lesions could be explained by the presence of stem cells as those odontogenic lesions contain a small number of stem cells. Many odontogenic tumors have been reported to originate from stem cells that present in remnants of the dental lamina. The maintenance of stem cells in early dental development is regulated by variety of transcription factors such as OCT-4, SOX-2, CD44, Nanog, Stat-3 and c-Myc. The aim of this study is to evaluate and compare the immunoexpression of two stem cell markers, which are CD44 and c Myc, in dental follicles and in benign epithelial odontogenic lesions. The study included 8 specimens of dental follicle, 6 specimens of inflammatory cysts, 8 specimens of odontogenic keratocyst and 8 specimens of dentigerous cysts. All cases of dental follicles showed positive immunoreaction for the two markers. Regarding c Myc all cases showed +ve immunoreaction except (OKC) were -ve. Regarding CD44 all cases showed +ve immunoreaction. Results of the present study characterize the presence of stem cells in dental follicle and in benign odontogenic lesions illustrating their role in the pathogenesis of these odontogenic lesions.