016.Understanding of bone augmentation technique in different applications

PROF. KHALID AL-RUHAIMI
College of Dentistry, King Saud University,Riyadh, Saudi Arabia

Finding an ideal bone substitute material for grafting has been the goal of researchers for many years, with varying degrees of success. Several bone substitutes have been popularized during the past 10 years and used often by clinicians who deal with ridge augmentation and the reconstruction of osseous defects.

Different grafting materials have been used to augment the bone in deficient sites. These materials include filling materials that serve as a scaffold for new bone growth (osteoconduction), growth factors that transform undifferentiated mesenchymal cells into osteoblasts (osteoinduction), autogenous bone grafts in the form of particles or blocks that have both osteoinduction and osteoconduction properties, and guided bone regeneration membrane (GTRM) based on the concept of using a barrier to separate bone from soft tissues and at the same time creating a space into which a new bone can grow.

The ideal bone substitute should possess the following characteristics: it should be biologically compatible, non supportive of local pathogens or cross-infection, osteogenic (ie, facilities bone cell ingrowth), it should match with the physical and chemical composition of natural bone trabeculae and provide scaffolding for new bone ingrowth; it should be resorbable and osteotropic (ie. Enhance bone formation by its chemical or structural characteristics); it should provide calcium and phosphate sources; and it should be microporous and easy to handle.

Autogenous bone graft is the golden mine for a reconstructive surgeon, however, the application of autogenous bone graft as onlay to augment resorbed ridge may lead to at least 50% of resorption of the grafted bone. Therefore, one should look to other options that reduce this phonemon by sandwitch the grafted bone at the middle of the resorbed ridge or look at other alternatives such as distraction osteogenesis.

This paper explain how to understand bone healing with augmenting bone graft, which graft material is the best to select and to use based on understanding the ideal criteria for bone substitutes. What addition that could facilitate and accelerate bone remodelling. Where bone defects that could be used with either bone substitute, autogenous graft or other modalities such as distraction osteogenesis to augment the bony defect with the best predictable results.
Saudi Dental Journal 2006;18(SI)-Abstr.016

017.Lasers for dental treatment - Concepts, applications and research

PROF. LOH HONG SAI
  Faculty of Dentistry, National University of Singapore, Singapore

This paper reviews lasers in oral and maxillofacial surgery (Catone GA, Ailing CC: Laser Applications in Oral and Maxillofacial Surgery, 1^st ed. WB Saunders Co., 1997) and the literature henceforth for their current and future applications. Presently, there is a growing acceptance of their effectiveness in the management of intra-oral surface lesions with predictable, reproducible results. The experience to incise, vaporize and coagulate with favourable biological responses is consistent from fairly established parameters and techniques. They are practical for discrete oral soft-tissue lesions with no evidence of malignant transformation. Dysfunction is minimal with reduced tissue manipulation and instrumentation. Overall cure rate for premalignant lesions is good and laser ablation for difficult malignancies yields better aesthetic results. Photocoagulation and thermolysis by selective laser absorption benefit vascular and pigmented lesions. Laser surgery provides better pre-prosthodontic outcomes. Perio-endodontic applications are enhanced with histochemical changes. Laser-induced immunomodulation is promising for oral lichen planus and related conditions. Minimally invasive, cosmetic and laser-assisted uvulopataloplasty procedures are on the rise. Cellular changes and the current understanding of their mechanisms improve pain management with low level laser therapy, especially for post-operative discomfort, trigeminal neuralgia and TMJ disorders. There is a growing confidence of its scientific basis and higher curative energy levels. The future is bright with improved instrumentation; adaptations of new systems / devices; controlled cell modifications in wound healing and pathological conditions; and in further imaging and sensing applications (Goldman L: The Biomedical Laser, 1^st ed. Springier-Verlag, 1981).
Saudi Dental Journal 2006;18(SI)-Abstr.017

018.The state-of-the-art surgical correction of dentofacial deformities

PROF. ASHRAF F. AYOUB
Biotechnology and Craniofacial Section, Glasgow University, Glasgow, United Kingdom

The aim of this presentation is to illustrate the complexity of dento-facial deformities and the need for multidisciplinary approach for proper management of these cases. The audience will be made aware of the treatment options available and the need for close cooperation between the various disciplines involved. The presentation will demonstrate surgical techniques, using video clips, and will cover the following aspects:

1. Assessing patients
2. Diagnosing facial deformities
3. Predicting facial changes following orthognathic surgery
4. Basic manual and computerised tracings of lateral cephalometric radiographs
5. Orthognathic surgical planning and prediction using articulated study models
6. Surgical techniques
7. Post-operative care

Al Baraha Hospital, Ministry of Health, Dubai, United Arab Emirates

Very young children and older ones fall. How do we manage these unpleasant incidents? This presentation will review different trauma episodes involving primary teeth in toddlers, from simple to more severe, discussing diagnosis and treatment planning. It will also review trauma to permanent teeth from displacement, crown fractures and avulsion: from parents' surprise and deception to children's happy and big smiles.
Saudi Dental Journal 2006;18(SI)-Abstr.019

DR. WALID M. SADIG
College of Dentistry, King Saud University, Riyadh, Saudi Arabia

Prosthodontic rehabilitation entails the performance of all the necessary procedures to produce optimum function, acceptable esthetic and maintainable restorations. The ultimate goal of any totally edentulous implant patients is to replace their missing teeth with a fixed restoration rather than removable. The number of GP's who said that they surgically place implants themselves has increased by 50% in just one year. In this presentation, a step by step procedure of implant supported full mouth rehabs will be presented. The approach is simple, easy, and inexpensive and besides being within the capabilities of general practitioners, it fulfills the objectives of complete rehabs.
Saudi Dental Journal 2006;18(SI)-Abstr.020