DR. PHILIPPE SOUHAID 
 Beirut, Lebanon

Many studies all over the world have suggested that pain is one of the major barriers in seeking dentistry. How pain is created and how individual can cope with it from early childhood to adulthood will be discussed in our first part. In the second part, clinical approach will be presented by taking cases from the pediatric ward, the orthodontic therapy and the adulthood life. Finally, a protocol will be established based on evidence dentistry related to the psychological and pharmacological approach.
Saudi Dental Journal 2006;18(SI)-Abstr.041

DR. ABDULLAH AL-QURASHI,DR. AHMED AL-YAMANI
King Fahad General Hospital

Osteodistraction is the process of generating new bone by stretching the healing callus between two vascularized bone surfaces that are separated by gradual distraction. Distraction osteogenesis has gained acceptance and has been used widely during the past 40 years by orthopedic surgeons. Snyder and associates first reported the experimental lengthening of the canine mandible in 1973. In 1992, McCarthy et al. reported the first clinical series in which the hypoplastic human mandible was corrected in length by gradual distraction. Thereafter, several authors have designed different types of distraction appliances and have provided their experience. One of the longest series is that of Molina and Ortiz Monasterio in 1995, with 106 patients in which progressive distraction of the mandible was accomplished. In this presentation, the experience with mandibular distraction and recent advances in osteodistraction such as the concepts of pumping of the regenerate and callus manipulation will be discussed.
Saudi Dental Journal 2006;18(SI)-Abstr.042

043.What a dentist should know about aesthetic surgical procedures

DR. AHMED AL-YAMANI
Faculty of Dentistry, King Abdulaziz University,Jeddah, Saudi Arabia

The addition of orthognathic surgery to the surgical armamentarium of the oral and maxillofacial is one of the single most important factors that have changed the scope of oral and maxillofacial surgery over the past 30 years. During the late 1980s, it was a common knowledge that the correction of skeletal deformities had a significant impact on the functional and aesthetic outcomes of these patients. However, the primary focus was toward skeletal, functional and occlusal concerns. Because of the significant impact that skeletal changes have on the overall aesthetics of the patient, it is a natural evolution that adjunctive aesthetic procedures would be incorporated into the overall treatment plan of these patients. Focus on the skeletal and aesthetic concerns in conjunction with functional and occlusal outcomes have again had a significant impact on the development of the scope of the specialty of oral and maxillofacial surgery. The purpose of this presentation is to familiarize the practitioner with the many adjunctive procedures that are available in the current armamentarium of the specialty of oral and maxillofacial surgery.
Saudi Dental Journal 2006;18(SI)-Abstr.043

DR. AWWAD AL-BISHRI
Al-Noor Specialist Hospital, Makkah, Saudi Arabia

Neurosensory disturbance (NSD) is a common complication to surgical corrections of mandibular deformities particularly when the sagittal split technique is used. With this technique the inferior alveolar nerve can be directly injured during surgery or damaged when trapped between the two bone segments. The incidence of sensory disturbance after sagittal split osteotomy varies considerably between centres. As an alternative to sagittal split osteotomy (SSO) the intra-oral vertical ramus osteotomy (IVRO) can be used to correct mandibular prognathism. The main advantage with this technique is the low incidence of nerve damage, which outweighs a period of postoperative intermaxillary fixation. The clinical studies were carried out to evaluate neurosensory disturbance with regard to kind of surgical procedure, direction of mandibular movement during surgery, the additional procedure of genioplasty, age, gender and the perioperative use of steroids. Whereas mandibular movement, additional genioplasty or gender did not affect the incidence, age and the perioperative use of steroids seemed to be factors to consider. As expected the incidence of NSD was lower with the use of IVRO than SSO. Also with the latter NSD was comparatively low, when steroids were given perioperatively. The observation that the introduction of the use of perioperatively administered steroids coincided with the decrease in the incidence of impaired sensibility prompted experimental studies to elucidate the role of the steroids. These showed that steroids facilitated nerve healing as reflected in functional tests and in the nerve morphology [recruited macrophages and nerve growth factors (NGF-R p75)l.
Saudi Dental Journal 2006;18(SI)-Abstr.044

PROF. NADIR BABAY
College of Dentistry, King Saud University,Riyadh, Saudi Arabia

The relationship between periodontal and pulpaldisease was first described by Simring and Goldberg in 1964. Since then the term "perio-endo" lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex. Knowledge of these disease processes is essential in coming to the correct diagnosis. This is achieved by careful history taking, examination and the use of special tests. The prognosis and treatment of each endodontic-periodontal disease type varies. Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies. The prognosis of these cases depends upon the severity of the periodontal disease and the response to periodontal treatment. This enables the construction of a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided. This presentation will highlight with the use of clinical cases, the latest information on the pathogenesis, classification, diagnosis and treatment.
Saudi Dental Journal 2006;18(SI)-Abstr.045