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Research paper thumbnail of Finite Element Analysis of the Stresses Induced by One-Piece and Two-Piece Dental Implants Supporting All-on-4 Implant-Supported Prostheses

The International Journal of Oral & Maxillofacial Implants

To find out the difference in the stresses induced by one-piece monophasic and two-piece dental i... more To find out the difference in the stresses induced by one-piece monophasic and two-piece dental implants supporting All-on-4 implant-supported prostheses using finite element analysis. Materials and Methods: Two finite element maxillary models were designed: In the two-piece model, two-piece dental implants were used, and in the onepiece model, one-piece dental implants were used. The dental implants were placed according to the All-on-4 treatment concept. The anterior implants were axially placed; however, the posterior implants were placed with a distal inclination of 15 degrees. In each model, the prosthetic superstructure was designed to be a titanium implant prosthesis with zirconia crowns. Three loading scenarios were applied in this study. The first scenario simulated biting function with a total load of 250 N. The second scenario simulated incision function in which 90-N horizontal static load was applied to the palatal surface of central incisors. The third scenario simulated biting in the presence of a cantilever. Results: In the three loading scenarios, the stresses were higher in the two-piece model. Higher stress values were recorded posteriorly rather than anteriorly in both models. Conclusion: One-piece dental implants induce lower stress values compared with two-piece dental implants when used in All-on-4 implant-supported prostheses.

Research paper thumbnail of Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation

BMC Oral Health

Background Debonding of ball attachments is one of the complications that annoy teeth supported o... more Background Debonding of ball attachments is one of the complications that annoy teeth supported overdenture wearers. The polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers are widely applied in the dental field. The purpose of the current study was to compare the tensile bond strength of ball attachments made of such materials and the commonly used titanium ones after 5 years of overdenture insertion and removal (5000 cycles) in addition to chewing simulation (1,200,000 cycle). Methods Extracted mandibular canines (N = 60) were randomly allocated into three groups and received ball attachments; titanium (group TI; N = 20), PEEK (group PE; N = 20), PEKK (group PK; N = 20). In each group, the samples were divided into two subgroups whereas tensile bond strength was measured pre aging (T0; n = 10) and post aging (T1; n = 10). Tensile bond strength was measured by the Pull out test using the Universal testing machine. Failure mode analysis was determined by examinatio...

Research paper thumbnail of Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear Finite Element Analysis study

Background: Correct choice of the implant design and the occlusal scheme is important for the suc... more Background: Correct choice of the implant design and the occlusal scheme is important for the success of implant supported restorations. So, the aim of the current study was to find out the difference in the stresses induced by the one piece dental implants designed to be used in the All-on-4® concept and the conventional two piece ones under simulated lateral occlusal schemes using nonlinear Finite Element Analysis.Methods: Two Finite Element models of the maxilla, implants, and prostheses were designed according to the All-on-4® concept. In the model TP, two piece dental implants were placed while in the model OP one piece dental implants were used. Two loading scenarios were applied to each model; the first one simulated a group function occlusal scheme while the second scenario simulated a canine guided one. Results: The highest stress value was recorded in the model TP with the group function occlusion and the lowest stress value was in the model OP with the canine guidance occ...

Research paper thumbnail of Short Length Versus Conventional Implants in Rehabilitation of Completely Edentulous Mandible

Ahmed Mohamed Abdel Aziem Lasheen , Engy Amen Tallat , Fardos Nabil Fathy Rizk , Mahmoud EL Mouta... more Ahmed Mohamed Abdel Aziem Lasheen , Engy Amen Tallat , Fardos Nabil Fathy Rizk , Mahmoud EL Moutassim Bellah Salah-Eldin EL Homossany , Heba Allah Tarek Mohamed Mahmoud . 1 Assistant lecturer – Department of Oral and Maxillofacial Prosthodontics – Faculty of Dentistry – British University in Egypt (BUE) – Cairo – Egypt. 2 Professor of Oral & Maxillofacial Prosthodontics Faculty of Dentistry – Ain Shams University – Cairo – Egypt. 3 Professor of Oral & Maxillofacial Prosthodontics and Vice Dean for Research and Post-Graduate Affairs Faculty of Dentistry British University in Egypt 4 Lecturer of Oral & Maxillofacial Prosthodontics Faculty of Dentistry – Ain Shams University – Cairo – Egypt.

Research paper thumbnail of The effect of different implant location in mandibular implant assisted partial overdentures restoring Kennedy class I cases on peri-implant bone level changes and patient’s satisfaction

Egyptian Dental Journal

Purpose: The aim of this study was to evaluate and compare two different implant locations in pre... more Purpose: The aim of this study was to evaluate and compare two different implant locations in premolar and molar regions in mandibular implant assisted partial overdentures restoring Kennedy class I cases. The parameters of evaluation were the peri-implant bone level changes, pocket depth around the last abutment and patient's satisfaction with the prosthesis. Materials and method: Twenty-eight partially edentulous patients with lower bilateral free-end saddle, having first premolar the last standing tooth opposed to dentate maxillary arch, were selected. For all patients chromium cobalt partial denture was constructed following the conventional steps. Proper planning for implant placement bilaterally was made, where participants were randomly allocated into two groups. In group I; the implant was placed in the premolar area while in group II; the implant was placed in the second molar area. Implants were inserted using two-stage surgical technique following the conventional loading protocol. After 3 months, implants were exposed and the attachments were picked up to the denture base fitting surface using self-cure acrylic resin and implant assisted partial overdenture was delivered. Pocket depth around the last abutment and peri-implant marginal bone height were evaluated at loading time, after 6, 9, 12 and 18 months follow up visits. In addition participants answered patient's satisfaction questionnaire in the sixth month follow up visit. Data collected were statistically analyzed. Results: Results showed statistically significant higher mean bone loss around the implants in group I compared to group II at measurements after 6m, 9m, 12m and 18m. In addition, group II showed statistically significantly higher mean pocket depth compared to group I at measurements after 6m and 18m. Visual analogue scale showed a statistically significant higher pain score in group II compared to group I regarding the mastication.

Research paper thumbnail of Evaluation of Different Kinds Of Occlusal Splints Therapy in the Management of Myofascial Pain

Egyptian Dental Journal, Apr 1, 2018

The aim of the study was to compare patient satisfaction with different types of stents using vis... more The aim of the study was to compare patient satisfaction with different types of stents using visual analogue scale and Pain report analysis. Materials and methods: Thirty dentulous patients were selected, based on the clinical examination, the patients were suffering from pain in the temporomandibular joint region that might be worse in the morning or associated with eating,tenderness of temporomandibular joint with palpation at rest and/or at function, pain and/or tenderness of masseter and temporalis muscle. The patients were randomly divided into three equal groups, ten patients in each group. Splints were constructed for the upper arch of each patient. Soft, hard and 3 Dprinted stents were fabricated. Pain intensity questionnaire (visual analogue scale) and Pain report analysis were used before treatment, after three months and six months. Results: Kruskal-Wallis test was used to analyze the ordinal scale date of the visual analogue scale and pain report analysis. There was significance difference between the three groups. (Soft, hard and three D printed) after three month and six month of using the stent. Wicoxon test was used to test for significance between the different groups at three months and six months. The Wilcoxon test for visual analogue scale at three months showed that the hard and 3D printed stent are statistically significant to soft splint. The same was for the six months period. While Wilcoxon test for pain report analysis at 3 months didn't show any statistical significance between the three groups, while at six month there was statistical significance between the hard splint and the 3 D printed splint with the soft splint. Friedman's test was used to compare between different time intervals inside the groups. There was a statistical significance between the three groups during the three months and six months interval time of the treatment. Conclusion: All patients improved over time. The results showed that both hard and soft splints are effective but the hard splint and the three D printed splints are more effective compared to soft splint.

Research paper thumbnail of COVID-19-related anxiety among dental students in two dental schools in Saudi Arabia

Journal of Pharmacy And Bioallied Sciences

Research paper thumbnail of Comparing Three Different Surgical Guides Protocol on the Marginal Bone Loss Around Implants in Implant Assisted Mandibular Overdenture

Egyptian Dental Journal

Aim of the study: This study was conducted to assess the efficacy of different guided surgery pro... more Aim of the study: This study was conducted to assess the efficacy of different guided surgery protocols on mean marginal bone loss around implants in implant assisted mandibular over denture. Materials and methods: Twenty-one edentulous patients were selected for this study. They were randomly divided into three different groups. In the first group implants were placed by free hand technique. In the second group partial limiting surgical guide was used; the surgical guide was used for pilot drilling. In the third group completely limiting surgical guide was used; the surgical guide was used for the whole drilling sequence. Mean marginal bone loss was measured using CBCT at 6 months, 12month and 18 months interval. Results were collected and tabulated for statistical analysis. Results: One-way ANOVA test showed no statistical significance between the three groups in all time intervals. Conclusion: Within the limitation of this study, no statistically significant differences could be found between the guided groups and the free hand group at the 18 months follow-up period.

Research paper thumbnail of Comparison of Peri-Implant Clinical Inflammatory Parameters Among Screw Retained Cad/Cam Metal Bar and Zirconia Bar for Patients with Reconstructed Mandibles

Egyptian Dental Journal

Background: Segmental resection of the mandible results in severe disturbance of chewing function... more Background: Segmental resection of the mandible results in severe disturbance of chewing function. Advances in microvascular surgeries and CAD/CAM technology helped with the prosthetic rehabilitation of reconstructed mandibles. Purpose: The aim of this study was to assess metal bar versus zirconia bar in patients with reconstructed mandibles that were rehabilitated with implant retained mandibular removable partial overdenture concerning the peri implant gingival index and probing depth. Materials and methods: fourteen patients were selected according to the inclusion criteria, the participants were stratified equally into two groups, patients were assigned to receive either metal bar or zirconium bar. Preparation of implant sites started with pilot drill followed by sequential drilling under copious refrigerated irrigation. Monthly follow up appointments were scheduled for each patient. After second stage surgery, abutments were secured to implant fixtures. Open top impression technique was used for bar fabrication using CAD/CAM technology. The bar was screwed in the patient's mouth and checked for passive fit. Construction of the implant assisted removable partial overdenture took place in the conventional way. Female part were picked up directly in the patient's mouth. Patients were recalled one week, 3,9 and 12 months after delivery for assessment of gingival index and probing depth. Results: Mann-Whitney U test was used to analyze the gingival index score between the two groups metal bar and zirconium bar. The metal bar group mean and standard deviation was 0.40±0.48 after 1 week and 0.36±0.32 after 3 months, 0.30±0.42 after 9 months, 0.20±0.42 after 12 months. While for zirconium group 0.30 ± 0.70, 0.28± 0.42 ,0.25±0.32, 0.10±0.32 respectively after 1 week,3 months ,9 months and 12 months. There was a statistical significance between the groups in 9 and 12 months, where P value was <0.01. Wilcoxon signed rank test was used to test for significance within each group during the time interval. There was a statistical significance inside each group during the time interval. Unpaired t test was used to analyze probing depth to test (3576)

Research paper thumbnail of Free Hand Versus Partial Limiting Design Computer Guided Surgical Stent (Vitro Study)

Egyptian Dental Journal

Aim of the study: Was to compare the accuracy of two different surgical techniques; free hand and... more Aim of the study: Was to compare the accuracy of two different surgical techniques; free hand and partial limiting, regarding the accuracy of implant position. Materials and methods: Four edentulous dummy mandible simulating human edentulous mandible were used (the model material duplicates type II~III hardness). A surgical stent was fabricated. The surgical stent was secured on the first and second mandibles and all the implants were placed using the partial limit technique; where the initial drill was used first using the stent. The subsequent drills were used free hand. The same stent was placed on the other two mandibles where the position of the implants was delineated using a marker, then the implants were placed free hand. The angles between the long axis of preplanned and real implants were recorded from both the preoperative implant plan & the post-operative implant representations on the resliced CBCT image & were compared to each other in degrees. The linear deviation of the post-operative placement was recorded in mm in coronal & apical positions from the pre-planned implants in both Mesio-distal & Bucco-lingual aspects, also the vertical linear deviation (deviation in depth), was recorded apically, taking the pre-operative implant plan as the reference by the aid of the software matching function. Results : The data was collected and statistically analyzed. The mean angular deviation for group A the free hand was 3.71 ± 2.58 degree while that for group B partial limiting was 1.72 ± 1.67 degree, this difference was statistically significant P<0.05. The mean buccolingual deviation for group A was 0.79 ± 0.66mm, while that for group B was 0.27 ± 0.24 mm, this difference was statistically significant P<0.05. The mean Mesio distal deviation was 0.94 ± 0.75mm while that for group B was 0.37 ± 0.35mm, this difference was statistically significant P<0.05. For the mean apical deviation for group A it was 0.51 ± 0.48 mm and that for group B was 0.32 ± 0.32 mm and this was not statistically significant. P>0.05. There was statistical significance difference between both groups concerning the angular deviation, Bucco lingual deviation and Mesio distal deviation, while apical deviation was not significantly different. Conclusion: Partial limiting surgical stent is more precise than free hand surgical technique concerning the angular deviation, Bucco lingual deviation and Mesio distal deviation. There is no statistical significant difference concerning apical position.

Research paper thumbnail of Comparative Assessment of different degree of retention of ERA attachment on the supporting structures of implant supported mandibular overdenture

Egyptian Dental Journal

Objectives: This research was carried out to evaluate the effect of different degree of resilienc... more Objectives: This research was carried out to evaluate the effect of different degree of resiliency of ERA attachment; white and grey nylon male components in mini-implant retained mandibular overdenture on the peri-implant crestal bone level. Materials and Methods: Twenty completely edentulous patients with maladaptive experience of wearing mandibular dentures were selected to participate in this study. Patients participating in this study were rehabilitated by maxillary complete denture and implant retained mandibular overdenture by four mini-implants with ERA head abutments. For all selected patients four mini implants 2.2 mm in diameter and 14 mm in length (ZIMMER ERA) were inserted in the interforaminal area following the non-submerged flapless surgical approach with the help of a modified transparent acrylic template. Standard clinical and laboratory techniques were followed for denture construction for all patients. Patients were randomly divided into two equal groups according to the resiliency of the male nylon insert. A white replacement insert was seated into the metal housing for group I, while a grey replacement insert was used for group II. Mesial, distal, buccal and lingual marginal bone height around the mini implants were evaluated, using the linear measurement system of the software (Ondemand 3D) with flat panel detector supplied by the cone beam CT. The measurements were carried out at the end of each follow-up appointment (at overdenture insertion, 6, 12 and 18 months post insertion). The marginal bone loss at different intervals was obtained by calculating the difference in bone height at that interval from the base line measurement and statistically analyzed. Results: The results of this study showed that there was statistically significant increase in the marginal bone height loss around the mini implants in both groups at the end of 18 months follow up. Comparing the two studied retentive elements of ERA attachment; statistically significant difference between the two groups was found at the end of 18 months follow up period, where group I showed less bone resorption in comparison to group II. There was also significant difference between both groups concerning the distal and the labial surfaces after 18 months.

Research paper thumbnail of EGYPTIAN EFFECT OF MATERIAL ON STRESS TRANSMISSION TO THE SUPPORTING STRUCTURES IN KENNEDY CLASS I RESTORED BY TELESCOPIC-RETAINED REMOVABLE PARTIAL DENTURE. (STRAIN GAUGE STUDY

Objectives: The aim of this in-vitro study was to compare the stresses transmitted to the abut-me... more Objectives: The aim of this in-vitro study was to compare the stresses transmitted to the abut-ments in mandibular Kennedy class I restored with telescopic-retained removable partial denture (RPD) made from two different materials; PolyEther Ether Ketone (PEEK) and Co-Cr alloy. Materials and Methods: One mandibular model representing Kennedy class I, with second premolars as the last standing abutments, was fabricated using epoxy resin. Poly Vinyl Siloxane (PVS) impression material was used to simulate the mucosa and the periodontal ligament. The acrylic first and second premolar teeth bilaterally were prepared to receive primary telescopic copings. The latter and two removable partial denture (RPD) frameworks were fabricated out of PEEK and Co-Cr alloy. The 2 frameworks were then processed into fully finished RPDs using heat cured acrylic resin and acrylic teeth following the conventional techniques. Four strain gauges were installed in the epoxy resin model 1 mm mesial to the socket of the 1 st premolar and 1 mm distal to that of the 2 nd premolar, on the right and left sides respectively; channel 1, 2, 3 and 4. A load of 100 N was applied to the area of the first molar unilaterally on the right side and then bilaterally. The same procedure was repeated six times. Data on stresses were then collected, tabulated and statistically analyzed using one-way ANOVA and Tukey HSD Test (P≤0.05). Results: In the unilateral loading condition, the highest compressive micro-strains were recorded at channel 3 for the Co-Cr alloy-group (-40±3.16 µm/m). While the least compressive micro-strains were recorded at channel 3 for the PEEK-group (-10±3.16 µm/m). The highest tensile micro-strains were recorded at channel 2 for the PEEK-group (540±10 µm/m). While the least tensile micro-strains were recorded at channel 4 for the PEEK-group (15±4.47 µm/m). In the bilateral loading condition, the highest tensile micro-strains were recorded at channel 2 for the PEEK-group (355±11.83 µm/m). While the least tensile micro-strains were recorded at the same channel for the Co-Cr alloy-group (50±3.16 µm/m). The highest compressive micro-strains were recorded at channel 1 for the PEEK-group (-170±11.4 µm/m). While the least compressive micro-strains were recorded at channel 3 for the Co-Cr alloy-group (-95±8.94 µm/m).

Research paper thumbnail of Finite Element Analysis of the Stresses Induced by One-Piece and Two-Piece Dental Implants Supporting All-on-4 Implant-Supported Prostheses

The International Journal of Oral & Maxillofacial Implants

To find out the difference in the stresses induced by one-piece monophasic and two-piece dental i... more To find out the difference in the stresses induced by one-piece monophasic and two-piece dental implants supporting All-on-4 implant-supported prostheses using finite element analysis. Materials and Methods: Two finite element maxillary models were designed: In the two-piece model, two-piece dental implants were used, and in the onepiece model, one-piece dental implants were used. The dental implants were placed according to the All-on-4 treatment concept. The anterior implants were axially placed; however, the posterior implants were placed with a distal inclination of 15 degrees. In each model, the prosthetic superstructure was designed to be a titanium implant prosthesis with zirconia crowns. Three loading scenarios were applied in this study. The first scenario simulated biting function with a total load of 250 N. The second scenario simulated incision function in which 90-N horizontal static load was applied to the palatal surface of central incisors. The third scenario simulated biting in the presence of a cantilever. Results: In the three loading scenarios, the stresses were higher in the two-piece model. Higher stress values were recorded posteriorly rather than anteriorly in both models. Conclusion: One-piece dental implants induce lower stress values compared with two-piece dental implants when used in All-on-4 implant-supported prostheses.

Research paper thumbnail of Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation

BMC Oral Health

Background Debonding of ball attachments is one of the complications that annoy teeth supported o... more Background Debonding of ball attachments is one of the complications that annoy teeth supported overdenture wearers. The polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers are widely applied in the dental field. The purpose of the current study was to compare the tensile bond strength of ball attachments made of such materials and the commonly used titanium ones after 5 years of overdenture insertion and removal (5000 cycles) in addition to chewing simulation (1,200,000 cycle). Methods Extracted mandibular canines (N = 60) were randomly allocated into three groups and received ball attachments; titanium (group TI; N = 20), PEEK (group PE; N = 20), PEKK (group PK; N = 20). In each group, the samples were divided into two subgroups whereas tensile bond strength was measured pre aging (T0; n = 10) and post aging (T1; n = 10). Tensile bond strength was measured by the Pull out test using the Universal testing machine. Failure mode analysis was determined by examinatio...

Research paper thumbnail of Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear Finite Element Analysis study

Background: Correct choice of the implant design and the occlusal scheme is important for the suc... more Background: Correct choice of the implant design and the occlusal scheme is important for the success of implant supported restorations. So, the aim of the current study was to find out the difference in the stresses induced by the one piece dental implants designed to be used in the All-on-4® concept and the conventional two piece ones under simulated lateral occlusal schemes using nonlinear Finite Element Analysis.Methods: Two Finite Element models of the maxilla, implants, and prostheses were designed according to the All-on-4® concept. In the model TP, two piece dental implants were placed while in the model OP one piece dental implants were used. Two loading scenarios were applied to each model; the first one simulated a group function occlusal scheme while the second scenario simulated a canine guided one. Results: The highest stress value was recorded in the model TP with the group function occlusion and the lowest stress value was in the model OP with the canine guidance occ...

Research paper thumbnail of Short Length Versus Conventional Implants in Rehabilitation of Completely Edentulous Mandible

Ahmed Mohamed Abdel Aziem Lasheen , Engy Amen Tallat , Fardos Nabil Fathy Rizk , Mahmoud EL Mouta... more Ahmed Mohamed Abdel Aziem Lasheen , Engy Amen Tallat , Fardos Nabil Fathy Rizk , Mahmoud EL Moutassim Bellah Salah-Eldin EL Homossany , Heba Allah Tarek Mohamed Mahmoud . 1 Assistant lecturer – Department of Oral and Maxillofacial Prosthodontics – Faculty of Dentistry – British University in Egypt (BUE) – Cairo – Egypt. 2 Professor of Oral & Maxillofacial Prosthodontics Faculty of Dentistry – Ain Shams University – Cairo – Egypt. 3 Professor of Oral & Maxillofacial Prosthodontics and Vice Dean for Research and Post-Graduate Affairs Faculty of Dentistry British University in Egypt 4 Lecturer of Oral & Maxillofacial Prosthodontics Faculty of Dentistry – Ain Shams University – Cairo – Egypt.

Research paper thumbnail of The effect of different implant location in mandibular implant assisted partial overdentures restoring Kennedy class I cases on peri-implant bone level changes and patient’s satisfaction

Egyptian Dental Journal

Purpose: The aim of this study was to evaluate and compare two different implant locations in pre... more Purpose: The aim of this study was to evaluate and compare two different implant locations in premolar and molar regions in mandibular implant assisted partial overdentures restoring Kennedy class I cases. The parameters of evaluation were the peri-implant bone level changes, pocket depth around the last abutment and patient's satisfaction with the prosthesis. Materials and method: Twenty-eight partially edentulous patients with lower bilateral free-end saddle, having first premolar the last standing tooth opposed to dentate maxillary arch, were selected. For all patients chromium cobalt partial denture was constructed following the conventional steps. Proper planning for implant placement bilaterally was made, where participants were randomly allocated into two groups. In group I; the implant was placed in the premolar area while in group II; the implant was placed in the second molar area. Implants were inserted using two-stage surgical technique following the conventional loading protocol. After 3 months, implants were exposed and the attachments were picked up to the denture base fitting surface using self-cure acrylic resin and implant assisted partial overdenture was delivered. Pocket depth around the last abutment and peri-implant marginal bone height were evaluated at loading time, after 6, 9, 12 and 18 months follow up visits. In addition participants answered patient's satisfaction questionnaire in the sixth month follow up visit. Data collected were statistically analyzed. Results: Results showed statistically significant higher mean bone loss around the implants in group I compared to group II at measurements after 6m, 9m, 12m and 18m. In addition, group II showed statistically significantly higher mean pocket depth compared to group I at measurements after 6m and 18m. Visual analogue scale showed a statistically significant higher pain score in group II compared to group I regarding the mastication.

Research paper thumbnail of Evaluation of Different Kinds Of Occlusal Splints Therapy in the Management of Myofascial Pain

Egyptian Dental Journal, Apr 1, 2018

The aim of the study was to compare patient satisfaction with different types of stents using vis... more The aim of the study was to compare patient satisfaction with different types of stents using visual analogue scale and Pain report analysis. Materials and methods: Thirty dentulous patients were selected, based on the clinical examination, the patients were suffering from pain in the temporomandibular joint region that might be worse in the morning or associated with eating,tenderness of temporomandibular joint with palpation at rest and/or at function, pain and/or tenderness of masseter and temporalis muscle. The patients were randomly divided into three equal groups, ten patients in each group. Splints were constructed for the upper arch of each patient. Soft, hard and 3 Dprinted stents were fabricated. Pain intensity questionnaire (visual analogue scale) and Pain report analysis were used before treatment, after three months and six months. Results: Kruskal-Wallis test was used to analyze the ordinal scale date of the visual analogue scale and pain report analysis. There was significance difference between the three groups. (Soft, hard and three D printed) after three month and six month of using the stent. Wicoxon test was used to test for significance between the different groups at three months and six months. The Wilcoxon test for visual analogue scale at three months showed that the hard and 3D printed stent are statistically significant to soft splint. The same was for the six months period. While Wilcoxon test for pain report analysis at 3 months didn't show any statistical significance between the three groups, while at six month there was statistical significance between the hard splint and the 3 D printed splint with the soft splint. Friedman's test was used to compare between different time intervals inside the groups. There was a statistical significance between the three groups during the three months and six months interval time of the treatment. Conclusion: All patients improved over time. The results showed that both hard and soft splints are effective but the hard splint and the three D printed splints are more effective compared to soft splint.

Research paper thumbnail of COVID-19-related anxiety among dental students in two dental schools in Saudi Arabia

Journal of Pharmacy And Bioallied Sciences

Research paper thumbnail of Comparing Three Different Surgical Guides Protocol on the Marginal Bone Loss Around Implants in Implant Assisted Mandibular Overdenture

Egyptian Dental Journal

Aim of the study: This study was conducted to assess the efficacy of different guided surgery pro... more Aim of the study: This study was conducted to assess the efficacy of different guided surgery protocols on mean marginal bone loss around implants in implant assisted mandibular over denture. Materials and methods: Twenty-one edentulous patients were selected for this study. They were randomly divided into three different groups. In the first group implants were placed by free hand technique. In the second group partial limiting surgical guide was used; the surgical guide was used for pilot drilling. In the third group completely limiting surgical guide was used; the surgical guide was used for the whole drilling sequence. Mean marginal bone loss was measured using CBCT at 6 months, 12month and 18 months interval. Results were collected and tabulated for statistical analysis. Results: One-way ANOVA test showed no statistical significance between the three groups in all time intervals. Conclusion: Within the limitation of this study, no statistically significant differences could be found between the guided groups and the free hand group at the 18 months follow-up period.

Research paper thumbnail of Comparison of Peri-Implant Clinical Inflammatory Parameters Among Screw Retained Cad/Cam Metal Bar and Zirconia Bar for Patients with Reconstructed Mandibles

Egyptian Dental Journal

Background: Segmental resection of the mandible results in severe disturbance of chewing function... more Background: Segmental resection of the mandible results in severe disturbance of chewing function. Advances in microvascular surgeries and CAD/CAM technology helped with the prosthetic rehabilitation of reconstructed mandibles. Purpose: The aim of this study was to assess metal bar versus zirconia bar in patients with reconstructed mandibles that were rehabilitated with implant retained mandibular removable partial overdenture concerning the peri implant gingival index and probing depth. Materials and methods: fourteen patients were selected according to the inclusion criteria, the participants were stratified equally into two groups, patients were assigned to receive either metal bar or zirconium bar. Preparation of implant sites started with pilot drill followed by sequential drilling under copious refrigerated irrigation. Monthly follow up appointments were scheduled for each patient. After second stage surgery, abutments were secured to implant fixtures. Open top impression technique was used for bar fabrication using CAD/CAM technology. The bar was screwed in the patient's mouth and checked for passive fit. Construction of the implant assisted removable partial overdenture took place in the conventional way. Female part were picked up directly in the patient's mouth. Patients were recalled one week, 3,9 and 12 months after delivery for assessment of gingival index and probing depth. Results: Mann-Whitney U test was used to analyze the gingival index score between the two groups metal bar and zirconium bar. The metal bar group mean and standard deviation was 0.40±0.48 after 1 week and 0.36±0.32 after 3 months, 0.30±0.42 after 9 months, 0.20±0.42 after 12 months. While for zirconium group 0.30 ± 0.70, 0.28± 0.42 ,0.25±0.32, 0.10±0.32 respectively after 1 week,3 months ,9 months and 12 months. There was a statistical significance between the groups in 9 and 12 months, where P value was <0.01. Wilcoxon signed rank test was used to test for significance within each group during the time interval. There was a statistical significance inside each group during the time interval. Unpaired t test was used to analyze probing depth to test (3576)

Research paper thumbnail of Free Hand Versus Partial Limiting Design Computer Guided Surgical Stent (Vitro Study)

Egyptian Dental Journal

Aim of the study: Was to compare the accuracy of two different surgical techniques; free hand and... more Aim of the study: Was to compare the accuracy of two different surgical techniques; free hand and partial limiting, regarding the accuracy of implant position. Materials and methods: Four edentulous dummy mandible simulating human edentulous mandible were used (the model material duplicates type II~III hardness). A surgical stent was fabricated. The surgical stent was secured on the first and second mandibles and all the implants were placed using the partial limit technique; where the initial drill was used first using the stent. The subsequent drills were used free hand. The same stent was placed on the other two mandibles where the position of the implants was delineated using a marker, then the implants were placed free hand. The angles between the long axis of preplanned and real implants were recorded from both the preoperative implant plan & the post-operative implant representations on the resliced CBCT image & were compared to each other in degrees. The linear deviation of the post-operative placement was recorded in mm in coronal & apical positions from the pre-planned implants in both Mesio-distal & Bucco-lingual aspects, also the vertical linear deviation (deviation in depth), was recorded apically, taking the pre-operative implant plan as the reference by the aid of the software matching function. Results : The data was collected and statistically analyzed. The mean angular deviation for group A the free hand was 3.71 ± 2.58 degree while that for group B partial limiting was 1.72 ± 1.67 degree, this difference was statistically significant P<0.05. The mean buccolingual deviation for group A was 0.79 ± 0.66mm, while that for group B was 0.27 ± 0.24 mm, this difference was statistically significant P<0.05. The mean Mesio distal deviation was 0.94 ± 0.75mm while that for group B was 0.37 ± 0.35mm, this difference was statistically significant P<0.05. For the mean apical deviation for group A it was 0.51 ± 0.48 mm and that for group B was 0.32 ± 0.32 mm and this was not statistically significant. P>0.05. There was statistical significance difference between both groups concerning the angular deviation, Bucco lingual deviation and Mesio distal deviation, while apical deviation was not significantly different. Conclusion: Partial limiting surgical stent is more precise than free hand surgical technique concerning the angular deviation, Bucco lingual deviation and Mesio distal deviation. There is no statistical significant difference concerning apical position.

Research paper thumbnail of Comparative Assessment of different degree of retention of ERA attachment on the supporting structures of implant supported mandibular overdenture

Egyptian Dental Journal

Objectives: This research was carried out to evaluate the effect of different degree of resilienc... more Objectives: This research was carried out to evaluate the effect of different degree of resiliency of ERA attachment; white and grey nylon male components in mini-implant retained mandibular overdenture on the peri-implant crestal bone level. Materials and Methods: Twenty completely edentulous patients with maladaptive experience of wearing mandibular dentures were selected to participate in this study. Patients participating in this study were rehabilitated by maxillary complete denture and implant retained mandibular overdenture by four mini-implants with ERA head abutments. For all selected patients four mini implants 2.2 mm in diameter and 14 mm in length (ZIMMER ERA) were inserted in the interforaminal area following the non-submerged flapless surgical approach with the help of a modified transparent acrylic template. Standard clinical and laboratory techniques were followed for denture construction for all patients. Patients were randomly divided into two equal groups according to the resiliency of the male nylon insert. A white replacement insert was seated into the metal housing for group I, while a grey replacement insert was used for group II. Mesial, distal, buccal and lingual marginal bone height around the mini implants were evaluated, using the linear measurement system of the software (Ondemand 3D) with flat panel detector supplied by the cone beam CT. The measurements were carried out at the end of each follow-up appointment (at overdenture insertion, 6, 12 and 18 months post insertion). The marginal bone loss at different intervals was obtained by calculating the difference in bone height at that interval from the base line measurement and statistically analyzed. Results: The results of this study showed that there was statistically significant increase in the marginal bone height loss around the mini implants in both groups at the end of 18 months follow up. Comparing the two studied retentive elements of ERA attachment; statistically significant difference between the two groups was found at the end of 18 months follow up period, where group I showed less bone resorption in comparison to group II. There was also significant difference between both groups concerning the distal and the labial surfaces after 18 months.

Research paper thumbnail of EGYPTIAN EFFECT OF MATERIAL ON STRESS TRANSMISSION TO THE SUPPORTING STRUCTURES IN KENNEDY CLASS I RESTORED BY TELESCOPIC-RETAINED REMOVABLE PARTIAL DENTURE. (STRAIN GAUGE STUDY

Objectives: The aim of this in-vitro study was to compare the stresses transmitted to the abut-me... more Objectives: The aim of this in-vitro study was to compare the stresses transmitted to the abut-ments in mandibular Kennedy class I restored with telescopic-retained removable partial denture (RPD) made from two different materials; PolyEther Ether Ketone (PEEK) and Co-Cr alloy. Materials and Methods: One mandibular model representing Kennedy class I, with second premolars as the last standing abutments, was fabricated using epoxy resin. Poly Vinyl Siloxane (PVS) impression material was used to simulate the mucosa and the periodontal ligament. The acrylic first and second premolar teeth bilaterally were prepared to receive primary telescopic copings. The latter and two removable partial denture (RPD) frameworks were fabricated out of PEEK and Co-Cr alloy. The 2 frameworks were then processed into fully finished RPDs using heat cured acrylic resin and acrylic teeth following the conventional techniques. Four strain gauges were installed in the epoxy resin model 1 mm mesial to the socket of the 1 st premolar and 1 mm distal to that of the 2 nd premolar, on the right and left sides respectively; channel 1, 2, 3 and 4. A load of 100 N was applied to the area of the first molar unilaterally on the right side and then bilaterally. The same procedure was repeated six times. Data on stresses were then collected, tabulated and statistically analyzed using one-way ANOVA and Tukey HSD Test (P≤0.05). Results: In the unilateral loading condition, the highest compressive micro-strains were recorded at channel 3 for the Co-Cr alloy-group (-40±3.16 µm/m). While the least compressive micro-strains were recorded at channel 3 for the PEEK-group (-10±3.16 µm/m). The highest tensile micro-strains were recorded at channel 2 for the PEEK-group (540±10 µm/m). While the least tensile micro-strains were recorded at channel 4 for the PEEK-group (15±4.47 µm/m). In the bilateral loading condition, the highest tensile micro-strains were recorded at channel 2 for the PEEK-group (355±11.83 µm/m). While the least tensile micro-strains were recorded at the same channel for the Co-Cr alloy-group (50±3.16 µm/m). The highest compressive micro-strains were recorded at channel 1 for the PEEK-group (-170±11.4 µm/m). While the least compressive micro-strains were recorded at channel 3 for the Co-Cr alloy-group (-95±8.94 µm/m).