Introduction: Temporomandibular joint dysfunction (TMD) is a clinically significant condition which can be a source of acute or chronic orofacial pain and dysfunction including limitation of mandibular movement. Arthrocentesis is joint lavage which washes out these inflammatory mediators, thereby, relieving pain. Objective: To evaluate the efficacy of arthrocentesis with and without the injection of piroxicam on TMD. Materials and methods: This study was conducted on twenty patients with clinical and radiological diagnosis of TMD included in the study divided into equal groups. Ten patients were subjected to conventional arthrocentesis with saline solution alone, other ten patients underwent arthrocentesis by injection of piroxicam. Patient's evaluation will be preoperatively and postoperatively following the procedure and after 1st, 2nd week, 1 and 6 months. Magnetic resonance imaging (MRI) was performed in both groups before starting the treatment. Results: Evaluation of assisted and unassisted mouth opening showed increase at all time intervals. There was significant improvement in pain, range of motion, joint effusion and joint sounds. Conclusion: Arthrocentesis combined with piroxicam injections is superior to arthrocentesis alone in reducing impairment in patients with TMD on its clinical outcome.

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Background:Patients under anticoagulant therapy who need tooth extraction, face the problem of intraoperative and postoperative bleeding which may be difficult to control. Some surgeons use the option of stopping the medication or altering its dose for three to four days preoperatively to obtain adequate hemostasis; however, this may carry the risk of thromboembolism.

Introduction: Placement of implants in the posterior maxillary region is usually complicated by maxillary sinuses pneumatization, post-extraction bone resorption, and unfavorable quality of alveolar bone. Hence, the height of the residual bone is reduced which makes placing the standard implant difficult. Maxillary sinus lifting is one possible solution.Objective: The aim of this study was to evaluate the clinical and radiographical maxillary sinus lifting technique without graft material versus sinus lifting technique with graft material.Materials and Methods: this study was made as a clinical randomized controlled trial, the study sample included 14 patients. The sample was selected to match the inclusion and exclusion criteria. The selected patients were divided into two equal groups, both groups had gone through lifting of maxillary sinus simultaneously with implant placement, group1: maxillary sinus lifting was made for seven patients in combination with implant placement without bone graft. In group2: maxillary sinus lifting was made for seven patients in combination with implant placement with bone graft (Osteon TM II bone graft material). Clinical and radiographic evaluation was done through 6 months post-operatively. Results:Regarding postoperative clinical evaluation, group 1 had mild pain and edema postoperatively than that of group 2. The postoperative radiographical evaluation bone was evidenced and recorded around all implants at six months postoperatively in both groups, however, no statistical significant difference was recorded between both groups in the amount of bone density formed after 6 months postoperatively.

INTRODUCTION:The orbital floor fracture results in disruption of bony continuity, enophtalmos, diplopia and herniation of orbital content which lead to a restriction in eye movement. Auotogenous bone graft remains as the gold standard for reconstruction of orbital floor defects, the anterolateral wall of maxillary sinus is considered as one of the donor site used in the reconstruction of the orbital floor defects, which has many advantages such as biocompatibility, strength, vascularization and has no immune reaction. In addition, its contour fits exactly the orbital floor defect, a simple harvesting technique from an intraoral donor site which minimizes its morbidity. OBJECTIVE: We aimed in the present study to evaluate the use of anterolateral wall of maxillary sinus clinically and radiographically in the reconstruction of orbital floor defects in ten patients. MATERIALS AND METHODS: All operated patients had more or less one or more signs and symptoms of orbital floor fracture as diplopia, enophthalmos, limitation of eye movements and progressive infraorbital nerve hypoesthesia. The graft harvested with peizosurgery from contralateral side of the fracture, the donor site is covered by a collagen membrane to prevent soft tissue infiltration. The harvested bone graft is adapted to the defect with no other means of fixation. The follow-up schedule was 3 days postoperatively then once weekly for two weeks and then monthly for 3 months. RESULTS: All patients with preoperative diplopia had significant improvement postoperatively. 8 patients out of 9 with preoperative ocular restriction had improvement in the postoperative follow up visits. 6 patients with preoperative enophthalmos showed improvement in the postoperative follow up visits. 7 patients with infra orbital nerve paresthesia preoperatively, all of them showed improvement in the follow up visits. CONCLUSION:The study concluded that the anterolateral wall of the maxillary sinus is a suitable material for orbital floor reconstruction, especially in cases of small to medium defects (< 3 cm2).