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Purpose This study compared piezoelectric (PE) and conventional drills (CD) for maxillary aesthetic zone implant insertion. Material and methods This was a prospective split-mouth study. Implants were divided into two groups. Beds were prepared with CDs in group I and PE in group II. The implant stability quotient (ISQ) of the mechanical implant stability (MIS) was measured intraoperatively. The ISQ of the biological implant stability (BIS) was recorded at postoperative second and fourth months. Marginal bone loss (MBL) and bone density (BMD) were measured in the first and second years after prosthetic loading. The osteotomy time was also documented for both techniques. P values Results Sixty implants in 30 patients were included. PE provided a significantly higher ISQ. All values were above 70 throughout the follow-up period. The mean of the ISQ for MIS was 63.78 ± 1.03 and 73.89 ± 1.05 in group I and group II, respectively (p = 0.003). PE needed significantly longer osteotomy time with a mean of 11.99 ± 0.839 min. The BIS quality had high stability in group II and medium stability in group I throughout the study period. Its values decreased in both groups. Group II had a lesser percentage of decrease. However, it was significant only at time intervals between intraoperative and two months' postoperative (p = 0.004). MBL and BMD demonstrated insignificant results. Conclusion The implant site preparation with PE devices should be preferred to CDs whenever possible, because they seem to enhance implant stability and osseointegration, especially at the initial stages of healing.

Despite the wide uses of mandibular distraction osteogenesis (MDO), no study appears to have evaluated the use of MDO and subsequent advancement genioplasty. This study addressed lower facial third aesthetics in a consecutive series of subjects with micrognathia who underwent MDO and subsequent advancement genioplasty. Standard cephalometric measurements were performed pre-MDO, at the end of consolidation, and at 1 week, 6 months, and 12 months after genioplasty. At the end of follow-up, questionnaires were given to measure patient satisfaction. Forty patients were included, 33 of whom underwent genioplasty. The mean patient age was 22.35 ± 1.12 years. Pre-genioplasty cephalometric measurements showed that all patients had a deficient chin position and projection; they were dissatisfied with their facial aesthetics. Post-genioplasty cephalometric measurements showed that the hard and soft tissue pogonion had moved significantly: 8.4 ± 2.3 mm and 11.0 ± 2.11 mm, respectively. According to the questionnaire, the patients were satisfied with the final results. The MDO reduced the amount of chin advancement and minimized relapses; the soft tissue response of the lower facial third was more sensitive to genioplasty than isolated MDO. MDO and genioplasty lead to a modest horizontal chin movement that achieves the preferred pogonion position and projection.

Purpose The aim of this clinical study was to prospectively measure the incremental changes in the maximum interincisal opening (MIO) after 1 cm gap arthroplasty, compare these changes between unilateral and bilateral cases, and emphasize the importance of the monitoring of the MIO for at least 24 months. Materials and methods This prospective study enrolled 26 patients with TMJ ankylosis either unilateral or bilateral. The fingers assessment method was used to measure the MIO preoperatively, intraoperatively, and monthly postoperatively up to 24 months. All the patients had undergone 1 cm gap arthroplasty to release the ankylosis. The changes in MIO measurements of unilateral and bilateral cases were statistically compared. The physiotherapy was performed until the measurements had normal stable values. Results All the cases showed a significant decrease in MIO at the first three months. At 6 months, the MIO continuously increased up to 1 year. There was no difference between the unilateral and bilateral cases. At the end of the follow-up, all measurements showed normal stable values. Conclusion The monitoring of MIO is important to detect the early signs of re-ankylosis. It is the only way that can be used in which the early signs cannot be detected in radiographs.

Objectives Pediatric maxillofacial fractures are less common as compared to adults, however, they may lead to serious complications. Methods The study aimed to retrospectively correlate demographic data, facial fractures characteristics, and patterns among pediatric patients who were managed at 3 of the governmental Egyptian Hospitals from 2008 to 2016, and discussing the treatment protocols. The study included 104 patients presented with maxillofacial traumas. Those with dentoalveolar and/or dental injuries were excluded. All the patients were treated by conservative approaches, except those in whom surgical interventions were mandatory. Results The mean age of 104 patients was 10.94 ± 3.92 years. The female/male ratio was 1:1.4. Females’ fractures were mainly due to falls (17.31%). Road traffic accidents (RTAs) were the most common cause in males, followed by sports injuries (17.31.8%), then assault (10.58%). The most prevalent site of fractures was the mandible (67.31%) in particular condylar fractures. All the fractures were healed successfully, but restricted mouth openings were the most common sequela. Conclusion The RTAs were the main cause. Males and condylar fractures have the highest predominance. The conservative treatment is still the treatment of choice in pediatric fractures. Pediatric fractures must be followed longitudinally to avoid post-traumatic sequelae.

Purpose Chronic oroantral fistulas (OAFs) are a challenging problem in oral and maxillofacial surgery, and the treatment success rate of OAFs is as low as 67%. Thus, the double-layered closure has been described. The purpose of this study was to evaluate the simplicity and effectiveness of using a palatal rotational flap and suturing of the sinus membrane perforation as a new technique for double-layered closure. Materials and Methods A prospective case series study was performed in patients who had chronic OAFs and were treated at Al-Zahraa Hospital from 2010 to 2013. The following demographic and clinical data were collected: age, gender, location of defect, size, etiology, signs and symptoms, postoperative healing, and complications. Under local anesthesia, fistulectomy and sinus irrigation were performed to control sinusitis. Under general anesthesia, the oral side of the fistulous tract was sutured with a purse suture. A palatal flap was reflected and sutured to the buccal tissue. Results Twelve patients 19 to 51 years old were enrolled in this study. All patients tolerated the surgical procedures; all surgical wounds healed uneventfully without recurrence. Conclusion Double-layered closure of OAFs is a straightforward, convenient, and successful technique that provides stable, strong, and double-sealed closure of chronic OAFs.