Purpose: To evaluate effect of PRGF intra articular injection in patients with internal derangement of TMJ using CT guided versus conventional puncture technique. Materials and methods: Twenty patients with internal derangement without improvement by conservative treatment were divided into two groups: Group I: ten patients underwent arthrocentesis followed by PRGF injection using conventional puncture by anatomical landmarks. Group II: ten patients underwent arthrocentesis followed by PRGF injection using landmark and confirmed by CT. All patients were assessed preoperatively and postoperatively at 1week, 3 and 6 months for pain level, maximum interincisal opening, lateral, protrusive movements, joint tenderness and disk position with MRI after 6 months. Results: In both groups, all clinical variables showed statistical significant discrepancy postoperatively, the discrepancy between both groups was not statistically significant and MRI showed no statistical significant change in disc position. Conclusion: CT confirmed accurate position and depth within TMJ upper compartment in different views, allowed correction with less puncture trials and decreased learning curve of TMJ puncture but it is expensive, time consuming and not available in clinics. Anatomical landmarks is easy and representable method for TMJ puncture but blind technique and needs skill. Single injection of PRGF found efficient in the treatment of internal derangement of TMJ.

Purpose: to evaluate the labial bone thickness (LBT) in the esthetic zone of the maxilla after insertion of dental implants: immediately, 4-6 weeks, and 3 months after tooth extraction, by using cone beam computed tomography (CBCT). Patients and methods: Fifteen cases, who had single non-restorable upper anterior tooth or an extracted tooth not exceeding 3 months, were involved in the study. The patients were divided equally into three groups. In group 1, implants were placed immediately after tooth extraction. In group 2, implants were inserted 4-6 weeks after extraction. In group 3, implants were inserted 3 months following tooth extraction. All implants were covered by bovine bone graft substitute (BBGS) and platelet rich fibrin (PRF) membrane. The LBT was measured immediately after implant insertion, six and 12 months of surgery by using (CBCT). The patients were examined clinically by assessing probing depth (PD), sulcus bleeding index (SBI), pink esthetic score (PES), and visual analogue score (VAS). Results: Successful osseointegration was observed in all patients, both clinically and radiographically. There was insignificant difference in the labial bone thickness between the 3 groups; however, the amount of bone resorption was considered significant only in group 1, at the implant shoulder, during the first interval of the follow up (immediate to six months postoperative). Conclusion: Preservation of LBT at the labial surface of the dental implants in the esthetic zone of the maxilla appears to be independent on the time of implant insertion after tooth extraction. It was possible to create and preserve a stable layer of labial bone over implant surface, by the application of BBGS and PRF membrane.

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Aim: This study aimed to compare between mini implants and short implants supported overdentures in completely edentulous patients with atrophic ridges not suitable for conventional implants. Materials and methods: Ten completely edentulous patients with severely resorbed mandible and age ranged between 55 and 60 years were selected for this study. Complete heat cured acrylic resin dentures were constructed for all patients. Patients were divided into two groups, each group had five edentulous patients, In Group I, each patient received two mandibular mini-implants at the canine site with a standard diameter 2.5 mm and standard length 10 mm, while in Group II, each patient received two mandibular short implants at the canine site with standard diameter 3.4 mm and standard length 10 mm. All implants in both groups were placed following immediate loading protocol. Patients were recalled for a follow-up period of 1 year, evaluating implants clinically for pocket depth and gingival index at baseline, then 3, 6 and 9 months intervals, and evaluating bone height loss radiographically at baseline, then 6, 9 and 12 months intervals. Results: Pocket depth and crestal bone height loss increased in patients using short implants than patients using mini implants, while gingival index parameter in all patients was not affected by using the two types of implants. Conclusion: Mini dental implants have a favorable effect on the supporting structure than short dental implants in both clinical and radiographic evaluation.

Purpose: To evaluate of the volumetric bone change after using liquid phase concentrated growth factor in open sinus lift surgery .Material and methods 12 pneumatized maxillary sinuses in edentulous or partially edentulous patients were divided randomly into 2 equal groups; Group (A), augmented by alloplastic bone graft Biphasic Calcium Phosphate (BCP). Group (B), augmented with BCP mixed with liquid phase concentrated growth factor (LPCGF). Visual Analogue Scale (VAS) was used to assess pain and swelling. CBCT was used to assess the volume by measuring height × surface area of augmented bone immediate and 6 months postoperatively. Clinical follow up period was at 1 st , 2 nd day then, after one week postoperatively. Results 12 sinus , bilateral 71.4%, unilateral 28.5%, female 42.8%, male 57.2% were subjected to sinus lift surgery. Mean age was 50y and average length of residual bone was 7 mm. There was no significant difference between the two groups regarding primary wound healing with percentage of success 71.4%. VAS scale representing swelling of 42.8% in group (A) and 28.5% in group (B). Pain score show decrease gradual till one week to be zero. In comparing between two groups, percentages of change in volume was highly significant (p=0.004) between two groups; in group (A) was 29.31±13.23 while, in group (B) was 2.58±1.75. Conclusion: Use of LPCG mixed with BCP bone graft to augment the sinus with open sinus lift surgery showed less bone resorption as it represented with low percentage of change in bone graft volume at 6 months postoperative .