Transforming growth factor β 1 (TGF β1) is a cytokine which is present normally in the synovial fluid of all healthy joints. Never the less, its concentration increases up to three folds in osteoarthritic joints. Thus, TGF β1 expression in TMJ/OA can be of value in predicting the therapeutic outcome of different treatment modalities on the progression of the disease according to the severity of the degenerative process [8-9]. Considering that TMJ/OA is a multifactorial condition with diverse clinical presentations made it a difficult ABSTRACT Objective: This study aims to assess the effectiveness of arthrocentesis followed by intraarticular injection of adipose derived stem cells versus hyaluronic acid in treatment of temporomandibular joint osteoarthritis and reversing the ongoing degenerative cascade. Evaluation was based on clinical radiographic and biochemical findings. Materials and Methods: The study included thirty patients suffering from TMJ/OA. Clinical criteria and Computerized Tomography (CT scan) confirmed the diagnosis. Patients were divided into two equal groups; both groups underwent arthrocentesis pursued by hyaluronic acid injection for Group I, and chondrogenic differentiated adipose derived stem cells for Group II. Synovial fluid samples were collected preoperative and at the end of the study (18 months) to assess the TGFβ1 concentration. Clinical data (maximal mouth opening, lateral, protrusive movements, pain and joint sounds) were collected at 3, 6, 12 and 18 months. CT scans were repeated at 18 months. Results: Group I showed initial improvement within clinical parameters but failed to sustain these results till the end of the study, no marked radiographic changes were noted. However, the TGF β1concentration showed significant decrease. Group II showed significant improvement within all parameters, Radiographic findings manifested remodeling of degenerative findings and TGFβ1 concentration was significantly decreased. Conclusion: Adipose derived stem cell is an effective therapeutic treatment for TMJ/OA. It subsided all related clinical dysfunction and abates the ongoing degenerative cycle.

Oro-antral communication (OAC) is the inevitable connection between the oral cavity and the maxillary sinus. The most reputable cause of the condition is the extraction of maxillary molars due to the close proximity of their roots to the antral floor which is very thin in this area [1,2] . Moreover, periapical infection, large cysts, tumors and trauma can all be potential causes of oroantral communication [3,4] . It is of utmost importance to close this patent connection as soon as it is recognized to preclude the development of sinusitis with subsequent fistula formation [5] . Several articles recommended the closure of this communication within 24 hours of the incident [6] .Affirmation on the presence of OAC is established through several procedures comprised of clinical examination including Valsalva test, Cheek blowing test and probing of the perforation site through the socket however, this specific technique is not favored anymore as it is associated with several complications as increasing size of the defect and the possible pushing of foreign bodies or bacteria into the maxillary sinus [7,8] . Clinical diagnosis must be followed by radiological confirmation to exclude the presence of any dental roots or foreign bodies near or within the vicinity of the antrum. Radiographs provide accurate assessment of the site and size of the defect. Radiographic maneuvers commonly used are periapical, panoramic view [9] . Computerized Tomography (CT) as well as Cone beam computerized Tomography (CBCT). Nowadays, CBCT is widely used due its high quality, available 3D images, low radiation dose and the accurate details with less artifacts than helical ABSTRACT Introduction: Oroantral communication is an uncommon, inadvertent incident resulting from various causes the most common of which is the extraction of upper molars. Immediate closure of the communication is highly recommended to avoid infection and subsequent fistulous tract formation. Cyanoacrylate tissue glue was introduced as a reliable method for flapless sealing of the communication without any of the complications associated with the surgical maneuvers. One of the oldest surgical procedures used for closure of the Oroantral communication is the buccal advancement flap which proved efficiency in complete closure of the defect with minimal related complications. Aim of the study: The study aims evaluate the immediate flapless closure of Oroantral communication using cyanoacrylates versus the buccal sliding advancement flap. Patients and Methods: Twenty patients suffering from instant oroantral communication were included in the study. CBCT was performed to each of them to confirm the diagnosis, patients were divided into two groups where Group I (Study group) patients were treated by sealing of the defect using periacry l90 HV while Group II (control group) patients performed Buccal sliding advancement flap. Clinical follow up including pain, facial swelling, recurrence of the defect and sulcular depth up were performed at day 1, 3, 7, 15 and 1 month. CBCTs were...