Introduction:The use of a buccinator myomucosal flap in combination with Furlow's Z-plasty during primary and secondary palatal repairs has been proposed by many authors to overcome some of the limitations of Furlow's technique. However, there have been no studies that quantitatively measured the effective palatal lengthening when the buccal flap is added. Patients and Methods: The buccal flap is routinely used during primary palate repair in order to fill the gap between the hard palate and reoriented palatal muscle sling. The soft palatal length was measured in the midline from the posterior edge of the hard palate to the base of the uvula. All patients were measured before starting the surgery and just after palatal closure in the standard position for cleft palate repair. Results: Seventy-three patients with cleft palate who were candidates for primary repair were included. The mean age at the time of operation was 11.4 ± 3.5 months. The mean preoperative palatal length was 21.36 ± 3.529 mm, whereas the mean postoperative palatal length was 29.64 ± 4.171) mm. The mean palatal length change was 8.29 ± 2.514 mm (P < 0.000). Conclusions: The Combined use of a buccinator myomucosal flap with modified Furlow's Z-plasty in primary cleft palate repair has proven effective for palatal lengthening and achieved tensionless closure without the need for relaxing incision. It also provided a pliable soft tissue attachment of the palatal muscles to the hard palate allowing for better muscle function and mobility.

INTRODUCTION: piezosurgery device was originally developed for the atraumatic cutting of bone as it produces microvibrations and specific ultrasound frequency (25-29 kHz). This new ultrasonic cutting method will be an alternative to conventional methods of oral surgery. OBJECTIVES: This study compares the use of piezosurgery and conventional technique in mandibular radicular cyst enucleation and this was estimated by clinical and radiographic analysis. MATERIALS AND METHODS: This study was conducted on fourteen patients selected from the Outpatient Clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University. Patients with radicular cyst in jaw region were diagnosed clinically and radiographically. The patients were randomly divided into two groups, seven patients were treated using piezosurgery and other seven patients were treated using conventional surgical procedures. Intraoperative and postoperative evaluation was carried out to monitor soft tissue damage, manipulation complexity, pain, infection and tissue dehiscence at 1 st , 2 nd , 7 th day and after one month postoperatively. The bone healing and bone density was determined radiographically after 3 and 6 months postoperatively using Cone Beam Computed tomography. RESULTS: no soft tissue damage or manipulation complexities were observed in both groups, less bleeding was observed intraoperatively in piezosurgery group. Healing was uneventful with no signs of dehiscence in piezosurgery group with lower pain score than in control group. There was a significant decrease in the surface area of the bone defect in the piezosurgery group compared to control group along the follow up period. The improvement in the bone density was greater in the piezosurgery group than in the control group, with percent of difference 33.42% on the 3 rd month and 63.84% on the 6 th month. CONCLUSIONS: Piezosurgery is effective in cyst enucleation as it accelerates bone healing and reduces intraoperative and postoperative complications.

Background:The orbital floor is one of the most frequently injured areas during facial trauma. Their proper treatment is crucial for prevention of orbital complications as diplopia, limitation of ocular motility and enophthalmos. Cortical lamina is a collagenated cortical bone of heterologous origin that is used in grafting of non-load-bearing areas.Objective: To evaluate clinically the use of cortical lamina in the reconstruction of orbital floor defects. Materials and Methods:Ten patients with orbital floor defects less than 2cm were associated with one or more of the following complications; binocular diplopia, enophthalmos, limitation of ocular motility or infra orbital nerve dysfunction, were indicated for orbital reconstruction using cortical lamina xenograft. The follow-up schedule was 1week and 1, 3, 6 months postoperatively.Results: Orbital complications had been resolved in all patients. Only infra orbital nerve dysfunction continued in 7 patients where 3 of patients recovered after 3 months and the other 4 have recovered after 6 months.

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INTRODUCTION:Osteotomies done for implant placement has been classically performed using drills of various shapes to conform the site to the implant's geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis, representing a significant risk for failed osseointegration. As an alternative, ultrasonic drilling for implant placement allows precise and effective bone cutting without damaging adjacent soft tissues. OBJECTIVES: This study evaluated the effect of Piezoelectric drilling in decreasing the peri-implant marginal bone loss as well as increasing the implant stability values throughout a 6 months healing period. MATERIALS AND METHODS:A clinical and radiographic study with a split-mouth design was carried out on 10 patients. Each patient received two implants in both sides of anterior maxilla, one implant was placed with piezoelectric drilling (study group) and the other was placed with conventional drilling (control group). Assessments included measurements of implant stability using Osstell and measurements of the linear changes in the peri-implant marginal bone using cone beam computed tomography images. Measurements were done immediately post-operative, at 3 months and 6 months. RESULTS:The clinical and radiographical results of the Piezoelectric study sides were better than the conventional control sides. Marginal bone loss was significantly lower in the study group. Implant Stability Quotient (ISQ) values were significantly higher in the study group at the immediate time of placement and at 6 months. CONCLUSIONS:Within the limitations of this clinical trial, it can be concluded that the piezoelectric drilling for implant placement in the anterior maxilla is a successful option for reducing marginal bone loss and increasing implant stability throughout the healing period.