ObjectivesThe aim of this study was to evaluate clinically and radiographically alveolar Bone dimensional Changes after flapless immediate implant placement. Subjects and methods: Thirty-two patients were divided into two groups; Group A (control group): received flapped immediate implants combined with xeno graft. Group B (Test group): received flapless immediate implants combined by xeno-graft. Evaluation includes Presence of infection. Wound dehiscence. Implant exposure. Graft exposure or loss. Soft tissue dehiscence. Implant stability. Buccal bone height and lingual bone height of the extracted socket. Ridge width. Results: buccal bone height, flapless group showed a significant lower (0.09 mm) Change than flap (1.13 mm). Ridge width, at 2, 4, 6 mm, flapless group showed a significant lower Change than flap. Flapless group showed significant higher implant stability than flap. Conclusion: The flapless group has shown a lower reduction in height and width after placing immediate implants and filling the residual gap with an organic bovine bone. More ridge reduction was observed for the flapped group.

Objective: The present study was performed to evaluate immediate implant placement with socket-shield technique versus using bone graft filling the jumping gap in the form of sticky bone in maxillary aesthetic zone. Subjects and Methods: Sixteen patients were included in this study (n=16), they were divided into two groups: group (I): eight patients were subjected to socket shield procedure with immediate implant placement. Group (II): eight patients were subjected to immediate implant placement with sticky bone in the jumping gap. After surgery each patient were evaluated clinically for: pain values, esthetic results using pink esthetic score (PES) and implant stability using Osstell device. All patients received immediate and 6 months postoperative CBCT to assess bone density and the dimensional changes in the labial bone plates. Results: The mean vertical bone loss value after 6 months in group I was 0.28 ± 0.13 mm contrary to group II which was 0.46 ± 0.19 mm which was statistically significant. The mean horizontal bone loss value after 6 months in group I was 0.17 ± .099 mm while in group II it was 0.25 ± 0.13 mm which was statistically not significant. Conclusion: Both socket shield technique and using the sticky bone to fill the jumping gap preserved the labial bone thickness and height with superiority of socket shield in preservation of its height.

Objective: To evaluate injection of botulinum toxin in masseter and temporalis muscles as a treatment modality for temporomandibular disorders pain. Subjects and Methods: A total of 14 patients diagnosed with TMD were selected from the Out-Patient Clinic of the

Objectives: This study was designed to evaluate the effect of using tricalcium phosphate combined with platelet rich fibrin versus platelet rich plasma in post extraction socket clinically and radiographically at maxillary esthetic zone. Subject and methods: This study was conducted on 30 patient seeking extraction of at least one hopeless tooth, they distributed into 3 groups.10 patients for control group , 10 patients for test group (a) and 10 patients for test group (b). In control group the socket was left to heal spontaneously by clot formation. In test group (a) the socket was filled with beta-tricalcium phosphate as bone graft and platelet rich fibrin. In test group (b) the socket was filled with beta-tricalcium phosphate and platelet rich plasma. CBCT image was taken to compare the vertical, horizontal ridge dimension and bone density pre-operatively and 6 month post-operatively. Result: There was statistically non-significant difference regarding the vertical height, bone width, buccal plate thickness and bone density in both groups pre-operatively. But after 6 months post-operatively there was statistically significant difference regarding three groups in all parameters. The test group (a) that represented βTCP and PRF showed a lower percentage of a change than test group (b) that represented βTCP and PRR than control group. Conclusion: The use of PRF accelerates socket wound healing after tooth extraction as noticed by reducing vertical and horizontal bone loss and maintaining favorable bone density values after 6 months postoperatively.