INTRODUCTION:A cleft is a universal and non-standardized defect. To overcome stigmatization; cleft repair is essential to normalize the facial appearance. Thus, different surgical techniques and modifications have been developed. These techniques are based on three surgical approaches: The straight-line (Rose-Thompson), rotation-advancement (upper lip Z-plasty), and the triangular flap (lower lip Z-plasty). OBJECTIVES: Comparing the effectiveness of rotation-advancement approach to the straight-line approach in repairing unilateral cleft lip. METHODOLOGY: A prospective control clinical trial of twelve patients with unilateral cleft lip (aged between 1-and 24 months) was conducted. These patients were randomly selected and equally divided into two groups of 6 participants, each group was operated on with Millard or Fisher incisions. Caliper measurements of the lip and nose were recorded preoperatively. The analysis was based on a quantitative and qualitative comparison of the cleft side versus the non-cleft side for 3 outcomes (the constructed philtral ridge, the degree of labial scar, and degree of nasal symmetry) which were all used to assess the aesthetic difference between the two incisions. These outcomes were measured postoperatively at 6 months. Both Chi-square and Mann Whitney tests were used for statistical comparison of outcomes. RESULTS:The nasal asymmetry improved in both groups with a better result in cases operated on with Fisher; which was statistically significant at (2.201 * (0.028 * ). Medial lip height was increased in both groups with no statistical significance. The difference was statistically significant for the increase of lateral lip height of both groups at a P-value of <0.05. CONCLUSION: Nasolabial appearance in both incisions was satisfactory. Lip dimensions were improved in both groups. Due to the ''BACK CUT'' use; the lateral lip height was better with the Millard. Meanwhile, the nasal symmetry showed better results with the Fisher due to the definite preoperative measurements. Therefore, neither Fisher nor Millard incision was predominantly better than the other.

INTRODUCTION:Compromised teeth with periapical pathologies are removed before dental implant placement and sockets are left to heal. Some clinicians began to immediately place dental implants in fresh extraction sockets associated with chronic inflammatory periapical lesions and these studies revealed high success rates. OBJECTIVES: To evaluate healing of dental implants placed in sockets with chronic inflammatory periapical lesions after socket debridement. MATERIALS AND METHODS: 10 patients received 10 implants that were immediately inserted in sockets associated with chronic periapical granuloma. A variety of clinical and radiological parameters were assessed. RESULTS: All implants were osseointegrated with satisfactory implant stability at the end of the 6-month follow-up period and with no signs of clinical mobility or infection. All periapical lesions healed with no radiographic signs of peri-implantitis or lesion recurrence. CONCLUSIONS: Implants could osseointegrate successfully when their placement was done immediately after extraction of teeth with periapical lesions, assuming that proper clinical measures, such as careful cleaning, socket debridement and curettage are undertaken prior to the implant surgical placement.

BACKGROUND: Modified Socket shield technique, is an approach used to help maintain buccal bone level after implant insertion. However, the significance of bone grafting of the gap between the labial shield and the implant, in improving bone regeneration and prevention of the soft tissue ingrowth, has been described. AIM OF THE STUDY: Evaluation of clinical and radiographic outcomes of using xenogenic bone graft on outcome of immediate dental implant placement using the modified socket shield technique. MATERIAL AND METHOD: 16 patients were divided into two study groups. Control group received an immediate implant with modified socket shield technique. Test group received immediate implant with modified socket shield and bone graft put in the buccal gap. Outcome measurement was primary and secondary implant stability measurement and radiographic evaluation. RESULTS: Patients in both groups experienced minimum to moderate postoperative pain and no postoperative edema was noticed. Peri-implant Bone Mineral Density (BMD) after 6 months for the test group showed to increase with a % change median of 39.4 % and this was found to be significantly higher than the control group. Implant secondary stability was found to be significantly higher in the test group with a median of 78 Implant Stability Quotient (ISQ) compared to 73 ISQ for the control group. CONCLUSION: Deproteinized Bovine Bone Mineral (DBBM) is effective in healing of peri-implant defect and provides an appropriate stability and enhanced Bone Mineral Density (BMD). However, this technique requires proper case selection and is considered highly sensitive.

INTRODUCTION:Condylar fracture is a common mandibular fracture which accounted for 25-40%. There is much controversy in condylar fracture diagnosis and management. For several years, the preference was toward closed reduction to avoid surgical complications. Nowadays the preference started to change towards open reduction because of the late complications that might happen in case of closed treatment. Numerous plate designs had been emerged for internal fixation of the condyle and subcondylar region. Trapezoidal Condylar Plates (TCP) has been developed particularly for the fixation of low and high subcondylar fracture. OBJECTIVES: comparison between the TCP and standard two miniplates in fixation of subcondylar fracture clinically and radiographically. METHODOLOGY: Twenty patients with subcondylar fracture were treated with open reduction and internal fixation, 10 patients underwent TCP fixation (Group I) and 10 patients underwent two miniplates fixation ( Group II). Intraoperatively, the application time for each plate type was compared. Postoperatively, clinical and radiographical follow up were in intervals of 1 week, 1 month then 6 months. RESULTS: Intraoperatively, TCP showed less application time and more convenient use than two miniplates. Clinically, most of the cases reached normal Helikmo index score at 6 months. the two treatment groups had no statistically significant differences. At 1 month, pain was subsided in all patients. The computed tomographs of the 20 patients indicated a proper anatomical reduction. Along the 6 months, all cases showed stable fixation without significant change in ramus height or condylar angulation. CONCLUSION: The use of TCP showed comparable results to two miniplates in fixation of subcondylar fractures.

INTRODUCTION:Implants placed immediately after tooth extraction; impose many challenges. One of them is the difference in size and form between the extraction socket and the simultaneously inserted implant. Soft tissue coverage of the implant area is considered substantial to attain bone filling adjacent to the implant. OBJECTIVES: Evaluation of free tissue graft of buccal pad of fat (BPF) for primary soft tissue closure with immediately placed implants in the maxillary posterior region. METHODS: Ten patients aged between 20 to 45 years were selected from the outpatient clinic of Alexandria University requesting a dental implant to replace an unrecoverable maxillary posterior tooth. One stage surgery including tooth extraction, placement of an immediate implant, bone grafting material and autologous soft tissue graft from the buccal pad of fat was carried out. Clinical and radiographical follow up were done for six months. RESULTS: 10 patients (6 females and 4 males; mean age 34 years) were followed for 6 months .Soft tissue healing, was uneventful with only minor postoperative complications. Bone density and bone thickness measurements were significantly improved after 6 months from implant placement with full bone recovery around the implants compared with the 3months results. CONCLUSION: Results of the study suggest that, the buccal pad of fat graft application is a new prospective modality for achieving primary soft tissue coverage over immediate implants. KEYWORDS: immediate implants, buccal pad of fat, primary soft tissue coverage. RUNNING TITLE: immediate implants with buccal pad of fat free graft.