INTRODUCTION: Maxillofacial injuries, such as soft-tissue injuries, dental injuries, or maxillary, mandibular, and zygomatic fractures; are the most common injuries treated by oral and maxillofacial surgeons. In the last few years polyetheretherketone (PEEK) material was recognized as a material for maxillo-facial and cranial reconstructions. OBJECTIVES: The aim of this study is to evaluate the use of custom made polyetheretherketone (PEEK) plate in the treatment of mandibular fracture. MATERIALS AND METHODS: 10 patients having non-comminuted recent mandibular fracture will be treated using custom made PEEK plates. Clinical follow up will be conducted after 24-hours, one week, 1 month, 3 months and 6 months. Also, a radiographic investigation will be performed after 6 months to estimate the mean bone density across the fracture line. RESULTS: Data will be collected, summarized and statistically analyzed using the suitable methods. CONCLUSIONS: Fixation of mandibular fracture with custom made PEEK plate provides satisfying clinical and radiographic results after 6 months follow up.

INTRODUCTION:Immediate implant placement is now accepted in clinical dentistry for reconstruction of partially or completely edentulous mandible or maxilla. OBJECTIVES:The aim of the study was to evaluate the role of Maxgraft bone rings on the marginal bone level around dental implants placed in fresh extraction sockets. MATERIALS AND METHODS: A randomized clinical trial was carried out on fourteen cases with freshly extracted sockets with age range 20 to 50 years. There were 2 groups, study group and control group, the sockets of the study group were filled with the new "Maxgraft bone ring" and an immediate placement of implants were carried out in the graft site, while the control group sockets had immediate implant placement alone. A clinical and radiological evaluation were carried out immediately postoperatively, after 3 & 6 months to assess the osteointegration of the implant placed and to measure the level of the marginal bone around the implant. After 6 months final prosthesis was delivered. RESULTS: Radiographic evaluation revealed increase in marginal bone level around implants placed in the Maxgraft bone rings than those placed alone with statistical significance (p1 =0.008) CONCLUSIONS: Increase in marginal bone level using the Maxgraft bone rings due to its osteoconductive properties supporting natural and controlled tissue remodeling together with the trabecular structure of the cancellous bone within the graft allow optimal graft revascularization, rapid formation of new bone tissue and bone remodeling.

INTRODUCTION: The success of implant therapy depends primarily on appropriate treatment planning and properly performed implant placement surgery.Guided implant surgery (template based guided cavity preparation and guided implant insertion) is effective to guide the implant placement.This can be achieved by means of a surgical guide Stent.Stents are designed in conventional methods or stereolithography which allows the fabrication of surgical guides from 3D computer generated models for precise placement of the implants. OBJECTIVES: Assess the accuracy of stereolithographic surgical stent to orientate implant insertion in mandibular free-end saddle areas. MATERIALS AND METHODS: A total of 12 implants will be placed in patients having mandibular free end-saddle areas selected from the outpatient section of the department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, after virtual implant planning with implant studio software, the implants will be inserted using stereolithographical design of surgical stent then measuring the deviation between the planned implant position before the surgery and the actual position of placed implant after surgical procedure. RESULTS: Evaluation of the accuracy of placement was done by measuring the overall deviations between virtually planned and surgically placed dental implants.The mean of total angular difference in implant with stereolithographic stent were 10.9 ± 9.4°.While The Mean of total coronal differences in stereolithographic guided implant were 0.96 mm ± 0.7 mm.The Mean of total apical differences in stereolithographic guided implant were 1.8 ± 1.3 mm CONCLUSIONS: The stereolithographic surgical template was sufficiently accurate in transferring the planned implant position to the surgical field relative to the implant angulation and point of entrance.

OBJECTIVE:The purpose of this study was to to assess the influence of computer-assisted mandibular reconstruction with iliac crest bone graft regarding the functional and morphological outcomes compared to the virtually performed surgery. Furthermore, the reliability of the measured values was evaluated. MATERIALS AND METHODS:The study is a prospective case series for computer-assisted mandibular reconstruction patients with iliac crest graft. Primary outcome variable was the functional and morphological outcome variables when correlated to the virtual preoperative values. The secondary outcome was deciding the reliability of the utilized evaluation methodology. All recorded data were documented, tabulated, computed, and analyzed using inter-class coefficient (ICC) test . Statistical significance was set at the 5% level. RESULTS: Nine consecutive patients were enrolled in this study. A highly statistically significant degree of agreement between the preoperative and postoperative measurements was recorded regarding all of the angular and linear parameters (P<0.001). Furthermore, an extreme degree of reliability was reported when the evaluation methodology was scrutinized. (ICC=0.9). CONCLUSION: Computer-assisted reconstruction showed accurate postoperative condylar position and morphological orthognathic measurements in mandibular resection cases with iliac crest graft reconstruction. Furthermore, the study showed the reliability of the chosen methodology to evaluate the computer-assisted reconstruction procedure.

INTRODUCTION:Alveolar ridge atrophy following tooth extraction remains a challenge for future implant placement. Post-extraction socket preservation and implant placement are two methods that are used to prevent significant post-extraction bone loss. OBJECTIVES: The aim of this study was to evaluate the role of hyaluronic acid when mixed with autogenous bone graft in alveolar socket preservation for future implant placement. MATERIALS AND METHODS: A split mouth randomized clinical trial was carried out in 10 patients, 20 mandibular extraction sockets of single rooted teeth with age ranged between 25-55 years, 10 sockets were grafted with autogenous bone graft only using Auto-Max TM bone harvester and the other 10 sockets were grafted with autogenous bone graft mixed with hyaluronic acid (Hyadent TM ). All sockets were evaluated clinically, radiographically, and histologically (after 2 months, core biopsy was taken before implant placement) then histomophometric analysis and delayed implant insertion were done followed by implant stability assessment. After 4 months, final prosthesis was delivered. RESULTS: Histological evaluation revealed rapid thick bone deposition with many well organized osteocytes as well as osteoblast lining of the bone surfaces in the study group and increased mean area percent of formed bone. Radiographic bone density changes were found to be statistically significant between the two studied groups. (P2= <0.001). CONCLUSIONS: The use of autogenous bone graft with hyaluronic acid appears to be more efficient in osteoconduction when compared with autogenous bone graft alone and could be a promising strategy for preservation of alveolar sockets.