Ziad Noujeim

New form of hidrotic ectodermal dysplasia in a Lebanese family

We report a sister and brother born to consanguineous parents presenting with severe hypodontia, fine hair, and onychodysplasia. Five other relatives are similarly affected. The comparison with other ectodermal dysplasias is presented and discussed. The possibility of a new autosomal recessive form of ectodermal dysplasia is raised.

Physicochemical characteristics of bone substitutes used in oral surgery in comparison to autogenous bone.

Bone substitutes used in oral surgery include allografts, xenografts, and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone, but little is currently known about their physicochemical characteristics. The aim of this study was to evaluate a number of physical and chemical properties in a variety of granulated mineral-based biomaterials used in dentistry and to compare them with those of autogenous bone. Autogenous bone and eight commercial biomaterials of human, bovine, and synthetic origins were studied by high-resolution X-ray diffraction, atomic absorption spectrometry, and laser diffraction to determine their chemical composition, calcium release concentration, crystallinity, and granulation size. The highest calcium release concentration was 24. 94 mg/g for Puros and the lowest one was 2.83 mg/g for Ingenios β-TCP compared to 20.15 mg/g for natural bone. The range of particles sizes, in terms of median size D50, varied between 1.32 μm for BioOss and 902.41 μm for OsteoSponge, compared to 282.1 μm for natural bone. All samples displayed a similar hexagonal shape as bone, except Ingenios β-TCP, Macrobone, and OsteoSponge, which showed rhomboid and triclinic shapes, respectively. Commercial bone substitutes significantly differ in terms of calcium concentration, particle size, and crystallinity, which may affect their in vivo performance.

Influence of Surgical and Prosthetic Techniques on Marginal Bone Loss Around Titanium Implants. Part I: Immediate Loading in Fresh Extraction Sockets

PURPOSE Delayed placement of implant abutments has been associated with peri-implant marginal bone loss; however, long-term results obtained by modifying surgical and prosthetic techniques after implant placement are still lacking. This study aimed to evaluate the marginal bone loss around titanium implants placed in fresh extraction sockets using two loading protocols after a 5-year follow-up period. MATERIAL AND METHODS A total of 36 patients received 40 titanium implants (Astra Tech) intended for single-tooth replacement. Implants were immediately placed into fresh extraction sockets using either a one-stage (immediate loading by placing an interim prosthesis into functional occlusion) or a two-stage prosthetic loading protocol (insertion of abutments after 8 weeks of healing time). Marginal bone levels relative to the implant reference point were evaluated at four time intervals using intraoral radiographs: at time of implant placement, and 1, 3, and 5 years after implant placement. Measurements were obtained from mesial and distal surfaces of each implant (α = 0.05). RESULTS One-stage immediate implant placement into fresh extraction sockets resulted in a significant reduction in marginal bone loss (p < 0.002) compared to the traditional two-stage technique. Whereas mesial surfaces remained stable for the 5-year observation period, significant marginal bone loss was observed on distal surfaces of implants after cementation of interim prostheses (p < 0.007) and after 12 months (p < 0.034). CONCLUSIONS Within the limitations of this study, immediate loading of implants placed into fresh extraction sockets reduced marginal bone loss and did not compromise the success rate of the restorations.

A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla

Purpose: The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol. Materials and Methods: Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant. Results: Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period. Conclusions: Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites.

Horizontal and Vertical Reconstruction of the Severely Resorbed Maxillary Jaw Using Subantral Augmentation and a Novel Tenting Technique with Bone from the Lateral Buccal Wall

AimThe aim of this study was to evaluate the effect of using the lateral wall bone in sinus lifting two-dimensional reconstruction on bone augmentation.Patients and MethodsTen patients affected by class V or VI maxillary atrophy with less than 3 mm of residual horizontal ridge were selected. Using a piezo-ultrasonic surgery tip bony lateral wall was cut. To expose native bone to the bone graft, multiple perforations, made through the cortical plate of the recipient site with a round bur. Once the bony buccal wall was adjusted it was fixed away from the ridge with two 1.5 x 13 mm bone fixation screws. Deficiencies created between the bony buccal wall and the ridge was filled with a mineralized cortical bone. A pericardium membrane was then placed on the graft. A biopsy for histologic evaluation was made.ResultsThe data analysis in bone volume changes reported significant differences between the anterior and posterior locations before and after grafting (p < 0.05). The biopsy shows mature cancellous bone with predominantly lamellar structure.ConclusionThe use of the lateral wall bone in sinus lift surgery showed significant increase in bone volume.

AIDS: an epidemiological study on correlation between HIV-related oral lesions and plasma levels of CD4, CD8 T lymphocytes counts and ratio among 50 patients.

Aim: The aim of the study was to evaluate oral manifestations of HIV /AIDS patients and to correlate their occurrence with plasma levels of CD4+, CD8+ counts and CD4/CD8 ratio. Study Design: A descriptive cross-sectional study. Place and Duration: Odontology Unit, St-Antoine Hospital, a twoyear study. Methodology: In a descriptive cross-sectional study, 50 patients infected with human immunodeficiency virus (HIV) were assessed. The relationships between oral lesions and CD4+, CD8+ cell counts and CD4/CD8 ratio were evaluated. Results: The mean CD4+ counts and CD8+ counts were 167.12 cells/mm 3 and 979.66 cells/mm 3 and the mean CD4/CD8 ratio were 0.25. All patients displayed at least one oral manifestation. The most common identified oral lesion was pseudomembranous candidiasis, accounting for 76% Original Research Article Berberi et al.; BJMMR, 6(9): 859-866, 2015; Article no.BJMMR.2015.261 860 (38/50) followed by periodontal disease 34% (17/50), herpetic lesions, and hairy leukoplakia 10% for each (5/50), gingivitis 8% (4/50), oral ulceration 8% (4/50), Kaposi’s sarcoma 6% (3/50), and Non-Hodgkin lymphoma 2% (1/50). Conclusion: The CD4+ count was decreasing and the presence of oral lesions were increasing in this study. No relation was found between the presence of oral lesions and CD4/CD8 ratio. Progression to AIDS was characterized by increased prevalence of some oral lesions such as candidiasis, hairy leukoplakia and Kaposi’s sarcoma. The clinical appearance of oral lesions was more pronounced when CD4+ count was low.

Dental and skeletal age estimations in Lebanese children: A retrospective cross-sectional study

Aims and Objectives: Assessing dental and bone ages is frequently required in a wide range of fields such as odontology, forensic science, as well as orthopedics. The aim of this study was to evaluate applicability of two methods of bone age assessment and two methods of dental age (DA) assessment for Lebanese children. Materials and Methods: Skeletal age (SA) of 260 orthodontic patients (124 males, 136 females divided into four groups each) was consecutively assessed using Greulich and Pyle and Fishmans SMI methods. DA was evaluated using both Demirjians and Willems methods. Mean age was 11.89 ± 1.38 years for males and 11.75 ± 1.58 years for females. Data were collected and statistically analyzed using the SPSS software (IBM SPSS Statistics, version 21, USA). The differences between estimated DA, estimated SA, and chronological age (CA) were compared by gender and age group. Results: Greulich and Pyle method showed nonsignificant difference with CA in male sample, while in both assessment methods, the difference between skeletal and CAs is significant in female sample. Results of Willems method in the whole sample suggested a statistically nonsignificant difference, when compared to CA. Demirjians method delivered higher mean value than Willems assessment in both genders. Conclusions: Greulich and Pyle method is accurate for SA assessment in males and only in one group of females, while it significantly overestimates age in all other female groups. Willems method is more suitable to assess DA in both genders. A strong correlation exists between both dental and skeletal assessment methods and CA.