Day :
- Clinical Dentistry | Advancements in Dentistry | Oral and Maxillofacial Surgery & Innovations | Oral Health | Prosthodontics & Periodontics | Cosmetic Dentistry | Endodontics and Hypnodontics | Public Health Dentistry
Chair
Eugene L Antenucci
Bay Dental Health, USA
Co-Chair
Hossam Nassar
Future University in Egypt, Egypt
Session Introduction
Maryam Ismail
Northwick Park Hospital, UK
Title: Orbital fractures and their management?
Time : 11:35-12:00
Biography:
Maryam Ismail has completed her BDS at the University of Liverpool in 2016. Since, she has completed one year in general dental practice as a foundation trainee and 2 years as a hospital trainee. She is currently at Dental Core Trainee in Oral And Maxillo-Facial surgery at Northwick Park Hopsital in London. She is particularly passionate about paediatric dentistry and orthodontics and her aim is to specialize in orthodontics.
Abstract:
Aim: Fractures of the orbit are a common occurrence following facial trauma. However, not all require surgical repair. Criteria for repair currently vary, depending on CT appearances, clinical features and patient’s preferences. This study looks at those patients attending Northwick Park Hospital oral and maxillofacial surgery department with orbital fractures in the last 3 years and their subsequent management.
Method: Data was collected retrospectively from 01/01/2015 to 22/11/2018. All patients within the Trust who had CT and X-Ray facial bones, CT orbits and MRI orbits were included. From this data, patients who had orbital fractures were identified. The hospital records were then reviewed, noting which patients had surgical management, the reasons for repair and timing of repair. Non-surgical cases and post operative complications were also recorded.
Results: These will be presented.
Conclusion: Currently, there are no rigid and evidence based guidelines that enable us to clearly decide management for orbital fractures. Practices may vary widely and should be based on risk benefit analysis. Our results will illustrate our departmental guidelines and may help others attain a clear idea of how often and when to repair orbital fractures.
Manar Galal Hamoda
National Research Centre, Egypt
Title: Thermomechanical treatment: A game changer in endodontic instruments
Time : 12:00-12:25
Biography:
Manar Galal Hamoda has completed her PhD from Ain Shams University. She is currently a Researcher of Endodontics in Department of Restorative and Dental Materials, Oral and Dental Division, National Research Centre, Cairo, Egypt. She is a Lecturer of Endodontics at Misr International University, Cairo, Egypt.
Abstract:
Aim: The objective of this study was to evaluate the effect of different thermomechanical treatments on the mechanical behavior of rotary files under bending and torsion conditions using finite element analysis.
Methods: A geometric model of a file (25/.06) with triangular cross section was created. The file FE model was built using CAD software. The same FE file model was used to create four models with different material properties, the data for the M-wire, CM wire, R-phase and NiTi alloys were obtained from the literature. The mechanical behavior of the four models under bending and torsion was analyzed mathematically in solid works software package.
Results: Under bending conditions the maximum Von Mises stress value was related to NiTi file model (330 MPa), followed by M-wire (311 MPa), then CM file model (191 MPa), while the least amount of stress value was related to R-phase file model (169 MPa). When torsion test was performed the maximum stress value was also related to NiTi file model (270 MPa), followed by M-wire (261 MPa), then CM file model (191 MPa), while the least amount of stress value was related to R-phase file model (188 MPa).
Conclusions: Thermomechanical treatment of rotary instruments resulted in improving the flexibility and the torsional resistance of these files.
Simrath Singh Mangat
King’s College London, UK
Title: Diagnosis and management of sialolithiasis; optimising patient pathways for the general dental practitioner
Time : 13:35-14:00
Biography:
Simrath Singh Mangat is a Member of the Oral and Maxillofacial Surgery team at King’s College Hospital, Denmark Hill. As a qualified dentist with a background in general practice and a Master’s in Pharmacy, he is well versed in the pharmacological effects of medications which can be a causative in salivary gland disorders. His history in dental practice makes him well suited to understand the complexities of primary care, whilst his experience in the OMFS department allows him to appreciate the entire patient and clinician journey. In this presentation he is supported by Dr Rafal Niziol, a dual-qualified OMFS Registrar and Ms. Ryba, a consultant in Oral and Maxillofacial surgery, with a keen interest in management of salivary gland disorders.
Abstract:
The prevalence of sialolithiasis in the UK population has been estimated to be 0.45%, accounting for 50% of all salivary gland disorders. Previously, this would have been treated with gland excision. However, this has recently been superseded with minimally invasive treatment options. The presentation of sialolithiasis can be subtle and varied ranging from simple obstructive symptoms to sialadenosis. Often the first signs/symptoms of these can lead to attendance to a general dental practitioner for advice. At the King's College London Oral and Maxillofacial Surgery department, we often receive referrals for management of such cases and the patient has not been appropriately counseled on the current non-operative symptomatic relief management strategies. It is important for the general dental practitioner to have a clear understanding of the pathophysiology of salivary gland obstructive diseases and their associated symptomatic and clinical presentations. A discussion with the patient prior to referral of secondary care regarding the differential diagnoses and the likely investigations and the management options would enhance the patient’s understanding, expectations and overall experience. Symptomatic relief between referral and secondary care consultation can enhance the pathway. A patient who has had simple conservative management instigated, prior to attending the consultation in secondary care, can potentially result in expedited treatment in hospital. We have reviewed the existing literature and aim to provide a strategy on clinical decision making for general dental practitioners faced with salivary gland disorders in practice. They will be able to provide initial therapy, formulate differential diagnoses and make prompt referrals to secondary care where appropriate. This should improve the patient experience and patient pathway to ensure effective management.
Tarun Nagpal
King’s College London, UK
Title: Medication-related osteonecrosis of the jaw (MRONJ): Information for general dental practioners
Time : 14:00-14:25
Biography:
Tarun Nagpal qualified from Kings College London in 2016 with a BDS, he then completed his foundation training in Surrey treating a wide array of patients from different demographics. He is a a member of the faculty of dental surgery and has obtained a Postgraduate Diploma in Primary Dental Care. He is in his second year of Oral and Maxillofacial training at Northwick Park Hospital, after completing a year at Kings College Hospital.
Abstract:
A justified amount of concern and confusion exists by GDPs in management of patients with a percieved risk of MRONJ. The condition itself when present is a major cause of morbidity and may severely affect the quality of life for some patients. The condition was traditionly associated with the bisphosponate groups of drugs however with the development of numerous other medication potentially causing similar conditions the term MRONJ has been coined.
Gupta Ashana
King's College Hospital, England
Title: Guidance for GDPs’ on temporomandibular joint dysfunction management in practice
Time : 14:25-14:50
Biography:
Gupta Ashana studied at University of Birmingham from 2012-2017 for Undergraduate training to obtain BDS. Vocational training was completed in Buxton, Derbyshire where treatment was given to a high population needs. Moving on, she returned to London, where she grew up to undertake a year in Oral and Maxillofacial surgery at the Kings’ College NHS Foundation Trust. Here, time is spent on call, in theatre, completing minor oral surgery and running clinics and consultations.
Abstract:
Objectives: Temporomandibular joint (TMJ) dysfunction encompasses pain and deterioration of the muscles mastication (MoM) and jaw joint. TMJD is a difficult condition to diagnose and manage and often general dental practitioners will refer to specialist services early on prolonging the delay in patients’ receiving appropriate care. In this article, guidance is provided for dentists to be made aware of TMJD signs, how to examine the TMJ, address particular causes of TMJD and primary management/ when to make an appropriate referral to seek specialist advice.
Methods: Data was collected from the maxillofacial department of King’s College NHS Foundation Trust of percentage clinic time spent on patients presenting with TMJD. It was found that over 60% of the patients seen in this period attended for primary management including jaw exercises and bite guards. This can be done in general practice prior to a referral, freeing specialist clinics for urgent cases. This prompted a guidance form to be created.
Conclusion: When collating a history for TMJ pain it is important to account for diet, stress, grinding habits, previous TMJD and occlusion. Examination should be categorized according to TMJ and MoM each palpated at rest and clenched. First stage management often involves advice, jaw exercises and bite guards used as a diagnostic tool as well as to relieve clenching. Regular reviews are required and escalation as necessary. If unsuccessful with previous methods, it may be necessary to take imaging and refer to physiotherapists. If all methods of management fail, a specialist in TMJD can be contacted.
Nehal Doshi
Northwick Park Hospital, UK
Title: Bilateral intraoral coronoidectomy to successfully treat trismus secondary to bilateral coronoid hyperplasia
Time : 14:50-15:15
Biography:
Nehal Doshi has graduated from the prestigious Queen Mary University of London in 2017 acheiving distinction in all five years. She was awarded multiple academic prizes and accolades including best overall student 4 years out of 5; best perfomance in clinical seen case presentation for her finals case; highest mark in Oral Surgery/Oral Pathology unseen case; she was also recipient of the Principal’s prize for outstanding academic achievement and nominated to represent the institution in the University of London Gold Medal competition. She has previously presented at national and european conferences and is currently working in oral and maxillofacial surgery within London Northwest University Healthcare Trust, UK.
Abstract:
Bilateral coronoid hyperplasia (BCH) is rare but established cause of facial pain and restricted mouth opening. It is characterized by a non-neoplastic elongation of the coronoid process into the infratemporal fossa. The corresponding interference on the zygomatic bone causes restriction in mouth opening. The bilateral form of coronoid hyperplasia occurs four times as frequently as the unilateral form. In previous reviews of the literature (McLoughlin et al, 1995) 79 cases of bilateral coronoid hyperplasia were reported until 1995 and then a further 47 cases upto 2010 (Mulder et al, 2012). The main stay of treatment is a surgical approach by peforming a coronoidotomy or coronoidectomy either via an intraoral or extraoral approach. We present a case of a 18 year old male who presented to our department with a restriction in mouth opening of 17 mm. He had associated facial pain and headaches for which he was seen by a facial pain team as well as neurology respectively. He subsequently underwent bilateral coronoidectomy via an intraoral approach. Post operative review revealed that he had resolution of trismus with a mouth opening of 34 mm and resolution of his facial pain and trismus as a result of surgical intervention.
Jamal Naim
University of Palestine, Palestine
Title: Fiber reinforced composite bridge: A case presentation
Time : 15:15-15:40
Biography:
Jamal Naim has completed his PhD from Free University to Berlin and the German Board in Orthodontics (Facarzt) from Charite in Berlin. He worked from 2003 to 2006 as a scientific researcher at the ortodontic department at the Charite in Berlin. From 2008 to 2018 he was the dean of the faculty of dentistry at the University of Palestine in Gaza. He has published about 6 papers as a coauthor in german speaking journals. Now he works as a lecturer at the University of Palestine and as a trainer in Orthodontics and Aesthetic Dentistry in private sector. He is the Head of the dental comittee at the Palestinian Medical Council in Gaza. He owns the largest Dental Center in Gaza with 25 employees.
Abstract:
Restorative dentistry is constantly evolving as a result of innovative treatment solutions based on new materials, treatment techniques and technologies. Composite materials are a prime example for excellent innovations in dentistry. Fibre reinforcement has increased the potential uses of composites within restorative dentistry. This presentation discusses fibre types, structure and the physical properties of fibre-reinforced composites, in addition to outlining some of the potential clinical applications of this group of materials, thus updating participants on the new treatment possibilities offered by these developments.
Farnaz Keyhanlou
Islamic Azad University, Tehran Medical Branch, Iran
Title: Comparison of a new bovine xenograft and Bio-Oss in ridge preservation following tooth extraction: A histologic and histomorphometric study
Time : 16:00-16:25
Biography:
Farnaz Keyhanlou has completed her education in Dental Medicine at Dentistry Faculty of Tehran Medical Sciences, Azad University, Tehran, Iran. She is a Researcher at Cranio-Maxillofacial Research Center at Faculty of dentistry, Tehran Medical Sciences, Azad University, Tehran, Iran. She is currently working as Dentist in a Clinic Supervised by Hamedan University of Medical Sciences, Hamedan, Iran.
Abstract:
Following tooth removal, the surrounding alveolar bone, which is a critical tooth supporting structure, undergoes inevitable remodeling resulting in marked osseous resorption. The bone alterations of post-extraction site compromises of ideal oral rehabilitation. Bone grafting in dentistry is still the key component to promote healing of bony defects. On this basis, it is confirmed that alveolar ridge preservation technique results in significantly less vertical and horizontal contraction of the alveolar bone crest when compared to spontaneous healing. The aim of this study was to compare the efficacy of a novel xenograft, BonePlus+B and Bio-Oss in socket. This randomized clinical trial composed of patients subjected to a minimum of 2 single root extractions in the same jaw. Seven patients (4 females, 3 males) with a mean age of 40±5.2 years, contributed 16 extraction sockets that were randomly grafted with either Boneplus+B (n=9) or Bio-Oss (n=7). After 5 months, bone samples were harvested for histological and histomorphometrical analysis. All data were analyzed using Mann-Whitney U test analysis with the P-value set at 0.05. There was no statistically significant difference in terms of socket preservation success between the two studied groups (P-value<0.05). The results of this study suggest that socket preservation with either BonePlus+B or Bio-Oss, has similar outcomes up to 5 months of healing following immediate grafting of fresh extraction sockets. BonePlus+B can be used as possible bone substitutes prior to implant placement that do not interfere with normal bone repair processes.
Sara Emad
Shiraz University of Medical Sciences, Iran
Title: The relationship between bone mineral density (by DEXA scan) and oral health status in Iranian women older than 30-year-old
Time : 16:25-16:50
Biography:
Sara Emad has completed her MD of Dentistry at Shiraz University of medical sciences. She has been a Member of Shiraz student research commitee for more than three years and was a pioneer of Dentistry workshops in Shiraz Dental University. She has more than 3 papers under publishment in reputed journals and is working on two proposals.
Abstract:
Background: As skeletal bones and teeth are tissues with similar structures and origins, it is possible that both can be affected by similar metabolic disturbances and the same process could lead to bone loss and dental problems. Therefore, we aimed to evaluate dental and periodontal condition in relation to bone mineral density (BMD).
Methods: Fifty-nine women older than 30 that had undergone dual-energy X-ray absorptiometry during 2016-2017, in Shiraz, Iran, were given dental (decayed, missing, filled teeth/DMFT) and periodontal examination (periodontal disease index/PDI, oral hygiene index/OHI). Their BMD based on T-score and Z-score was also recorded. Data were statistically analyzed using SPSS (22). Chi-square, independent samples t-test, regression test and ANOVA were used and P<0.05 was considered significant.
Result: There was a negative correlation between DMFT and T-score of spine and femur (r=-0.280, p=0.032 and r=-0.284, p=0.029 respectively) . No association was found between PDI and T-scores or Z-scores for BMD (p> 0.05). Also, there was a significant negative correlation between number of missing teeth and T-score of both femoral and spinal regions (r=-0.277, p=0.034 & r=-0.390, p=0.002 respectively); however, such an association was not found with Z-scores (p= 0.430 and p= 0.081 respectively). Additionally, a strong positive correlation was observed between OHI and DMFT. (r=0.440, p=0.008).
Conclusion: In this investigation, a negative association between BMD and oral health condition was found. It suggests that inadequate bone mass could coexist with a worse oral health condition; nevertheless, further studies are required to confirm that.
Noushin Janbakhsh
Ilam University, Iran
Title: Gingival biotype: Clinical diagnosis, prevention of related complications in Restorative Dentistry and introduction of a new method for biotype enhancement
Time : 16:50-17:15
Biography:
Noushin Janbakhsh has completed his dental school at the age of 24 years from Isfahan University and Postgraduate studies in periodontology and implantology from Shahid Beheshti University School of Dentistry. She is currently an Assisstant Professor at Ilam University and has published research papers in the feild of periodontology. She has presented the subject of gingival biotype and new techniques several times including EuroPerio 2018.
Abstract:
The definition of aesthetics in dentistry is now-a-days not limited to the teeth and restorations, but soft tissue look also contributes to the final aesthetic outcome. In order to prevent complications such as recession in restorative and implant treatments, it is crucial to evaluate and determine the gingival biotype far ahead of any treatment. Numerous classifications have been proposed for gingival biotypes including: thin/thick, thin scalloped/thick flat, etc. Amongst different parameters of gingival biotype determination, gingival thickness is the most significant. A variety of methods exist for evaluating gingival biotype which fall into two major categories: invasive (eg., transgingival probing or using spriders) and non-invasive (eg., Ultrasonic, CBCT, TRAN). To avoid complications after restorative treatments, it is important to enhance thin gingival biotype in advance. The most reliable method of doing is subepithelial connective tissue graft. In this presentation we introduce a minimally invasive grafting protocol for biotype enhancement in implants with dehiscence lesions.
Sana Rauf
Akhtar Saeed Medical and Dental College, Pakistan
Title: Maxillary sinus pneumatization and its relationship with vitamin D deficiency: A cross sectional study
Time : 17:15-17:40
Biography:
Sana Rauf studied and graduated with a Bachelor of Dental Surgery from Lahore Medical and Dental College in 2017. During her under graduation she was a Founding Member of ‘Sehat Organization’, which joined hands with multiple NGOs across the region to provide free medical and dental healthcare in poverty struck areas of Punjab. After completing her foundation year in 2018, she went on to join a research externship at Agha Khan University, Karachi to dive into the world of research, epidemiology and public health. She is currently working as a Registrar at Akhtar Saeed Medical and Dental College in Oral and Maxillofacial Surgery Department and plans on pursuing her master’s in public health in the near future.
Abstract:
Objectives: To identify any correlation and its severity with the levels of serum vitamin D with the level of maxillary sinus pneumatization.
Study design: Descriptive cross-sectional survey.
Setting: OPD, Oral and Maxillofacial Department, Fatima Memorial Hospital, Lahore.
Materials & Methods: Patients were independently recruited using random sampling. A sample size of 100 subjects met the inclusion criteria of serum vitamin D levels of the patients was done using liquid chromatography tandem mass spectrometry, also known as LC/MS/MS. While level of sinus pneumatization was recorded according to Sharan and Majdar classification of maxillary sinus pneumatization. Data was collected and entered into the statistical package for social science (SPSS) version 25.0 for analysis. Parametric analysis was performed that included the pearson’s chi- squared test to determine an association between excessive maxillary sinus pneumatization and hypovitaminosis. A p-value of <0.05 was defined as the level of significance.
Results: The ages of patients ranged from 20 to 40 years while the mean age patients recruited was 26.03±6.72 years. 56% of the participants were found to be severely deficient in vitamin D levels. While 32% were deficient followed by only 12% having insufficient levels of vitamin D. Whereas, level 4 excessive sinus pneumatization was the most common with 40% patients. Second highest level of sinus pneumatization were seen in level 2 which were 31% followed by level 1 pneumatization which was 18% of the total subjects in which the least levels of pneumatization were seen in level 3 with only 11% of the total subjects. There was no statistically significant relationship of age or gender with levels of maxillary sinus pneumatization and hypovitaminosis D (p>0.05). However, a statistically significant relationship was found between levels of hypovitaminosis and levels of pneumatization with a chi square value to be 0.002 (p<0.05).
Conclusion: There is a significant relationship between levels of hypovitaminosis and levels of pneumatization.
References
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- Iqbal R and Khan A H (2010) Possible causes of vitamin D deficiency (VDD) in Pakistani population residing in Pakistan. The Journal of the Pakistan Medical Association 60(1):1-2.
- Bener A A-AM, and Hoffmann G F (2009) High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatrica 61(1):15-22.
- Elsammak M Y, Al-Wossaibi A A, Al-Howeish A, Alsaeed J (2011) High prevalence of vitamin D deficiency in the sunny Eastern region of Saudi Arabia: a hospital-based study. Eastern Mediterranean Health Journal 17(4):317-22.
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