Objectives:The aim of the current study was to estimate change of cyst volume after marsupialization, evaluate bone formation and to determine the optimum time for enucleation.Patients and methods: A total of 21 patients suffering from large odontogenic keratocyst more than 3cm in its largest diameter were treated by marsupialization followed by enucleation. The inferior alveolar nerve length and affection, as well as the overall and percentage cyst volume reduction, were the primary outcome factors. Postoperative follow-up consisted of clinical and radiographic examinations 3 months, 6 and 9 months after marsupialization.Results: Healing was uneventful in all patients, at three months, six months, and nine months postoperatively, the cyst volume had decreased by 39.05%, 65.62%, and 82.67%, respectively. The first three months showed a greater increase in bone density and decrease in cysts volume than the following three months (P < .01). The total number of patients underwent marsupialization for an average of 280 days. Up to nine months after surgery, none of the patients had an OKC recurrence. Conclusion:Within the limitations of our study, the enucleation timing after marsupialization of OKC is determined by the decrease of cyst volume and increase of its density and showed relocation of the inferior alveolar neurovascular bundle. Nonetheless, additional research is required with a larger study population and a longer follow-up period.

Aim: to compare the outcome of allogenic bone sheets clinically and radiographically in posterior mandibular vertical augmentation in Luhr class III cases with simultaneous implant placement using autogenous versus xenografts. Patients and methods: this study was based on a total of 12 implants placed in 4 patients, 2 of which were males and 2 females. Patients were divided into 2 groups, both treated with implants placed with exposed threads 3 mm crestally and covered buccolingually with the laminar bone membrane; group 1 received autogenous bone obtained from the same surgical site using 4.5 diameter ACM bur mixed with PRP and packed around the crestally exposed implant threads. Group 2 received xenograft bone particles mixed with PRP and packed around the crestally exposed implant threads in the same manner. Results: CBCT was done pre-operatively, immediate post-operatively and 4 months post-operatively for each implant to compare the bone gain radiographically. In group 1, the mean amount of residual bone height pre-operatively was 7.8 mm (SD 0.86) and increased to 14.44 mm (SD 1.75) and 14.1 mm (SD 1.85) immediate and 4 months post-operatively, respectively. The mean amount of bone gain after 4 months was 6.3 mm, denoting a minimal amount of graft loss during the first 4 postoperative months was 0.27 mm (less than 2%). In group 2, the mean amount of residual bone height pre-operatively was 8.37 mm (SD 0.99) and increased to 12.86 mm (SD 1.75) and 12.53 mm (SD 1.65) immediate and 4 months post-operatively, respectively. The mean amount of bone gain after 4 months was 4.16 mm, denoting a minimal amount of graft loss during the first 4 postoperative months was 0.33 mm (less than 3%). Upon comparing bone gain in both groups, Group I (Autogenous) had a bone gain of 6.33 mm versus 4.16 mm for Group II (Xenograft). Denoting more gain in Group I (autogenous). While the amount of graft loss between the immediate and 4 months postoperative CBCT was less than 2% and less than 3% in the autogenous versus the xenograft group respectively. Conclusion: Cases initially lacking keratinized mucosa will need soft tissue intervention along with this technique. Exposure after 4 months appeared to have been too early, which lead to bone loss and exposed threads. Bilateral augmentation has led to patients using the grafted edentulous sites for mastication early following soft tissue healing, prior to prosthetics, which might suggest that tooth-bounded posterior edentulous sites might be a better candidate for such technique. Results were clinically different than radiographically in the CBCT, so longer lag time is recommended before loading.

Objectives: the purpose of this study was to compare the outcomes of Resorbable bioactive glass UNIGRAFT® alone in comparison with those combined with autologous platelets rich fibrin (PRF) on the bone regeneration after treatment of maxillary odontogenic cysts.Patients and Methods: A total of twelve patients suffering from large maxillary odontogenic cysts were randomly assigned into two groups, each group were formed of six patients. Enucleation with peripheral ostectomy was done. The bony defects were grafted by application of Resorbable bioactive glass (Unigraft; Unicare Biomedical, Laguna Hills, CA) UNIGRAFT® alone in group (I) while in group (II) UNIGRAFT® mixed with Platelet Rich Fibrin.Clinical assessment was performed in the postoperative follow up including, Pain and swelling scores which was measured using VAS at 1 weeks. Radiographic examination measuring the bone density of the bony defects using cone beam computerized tomography (CBCT) at 3 and 6 months post-operative follow up.Results: all cases were healed without any signs of postoperative complications. Results showed that after 3 and 6 months, group (II) had significantly higher values than group (I) (p<0.05). Within both groups, there was a significant difference between densities measured at different intervals, with value measured after 6 months being higher significant than pre-operative value (p<0.05). Conclusion:UNIGRAFT® mixed with PRF improved the bone quality rather than UNIGRAFT® alone.

Background: Radicular cysts are the most common inflammatory odontogenic cyst which can be treated with decompression especially in children with large cyst and has vital structures and or vital tooth.Purpose: to evaluate clinical and radiographic effectiveness of decompression as a conservative treatment in decreasing the size of a pediatric radicular cysts and reveal the effect of different variables such as impacted tooth angulation, cusp tip depth and cyst size on related impacted tooth eruption.Methodology: A healthy 10 children with average age of 9years old with unilateral radicular mandibular cysts. decompression was done incorporating a multipurpose space maintainer. Clinical and radiographic follow up was done.Results: Ten patients were treated by decompression and the volume reduction rate was 79.1%. The monthly reduction rate was better in lesions greater than 275 mm2 with -28.00 ± 20.05and -17.52 ± 7.05 in lesions lower than 275mm2 with statistical significant difference (p<0.05). Conclusion:Decompression is effective for the treatment of radicular cystic lesions in pediatrics as it enables eruption of the impacted teeth within the cyst and decrease morbidity and protects neighboring vital structures.