المصطفى وسام وهاب الحمادي

Abstract Purpose The aim of this study is to evaluate the therapeutic and analgesic effect of PBMT in management of trigeminal neuralgia. Methods A 42-year-old female patient was chosen for this study. She experienced severe, unilateral, electrical-like pain episodes originating from specific points on the right side of her face, including the zygomatic region, infraorbital area, lateral side of the nose, and the upper right portion of the upper lip. The pain episodes were typically triggered by specific activities, such as speaking or washing her face. The procedure utilized photobiomodulation therapy with an EPIC X 940 nm diode laser. The laser settings included a power of 4 W, laser beam diameter of 3 cm, spot size of approximately 7.07 cm², power density of 0.5 W/cm², continuous wave (CW) emission mode, and an exposure time of 30 s for each trigger point. The energy density was approximately 16.97 J/cm² per trigger point. Treatment sessions were conducted three times per week, with a total of 12 sessions. As for the points of application, laser irradiation was administered to each trigger area along the course of the maxillary branch of the trigeminal nerve. Results The results obtained from the study show a significant reduction in VAS after 12 sessions and after a period of 6 and 12 months postoperatively following PBMT. Conclusions According to the results obtained from the case report, PBMT was effective in reducing pain in patients with idiopathic TN and could be considered an adjunctive method to pharmacotherapy, offering more satisfactory results without adverse effects. To achieve the maximum therapeutic effect using PBMT, correct diagnosis and proper knowledge of laser-tissue interaction are essential.

Abstract Purpose The aim of this study is to evaluate the re-pigmentation following gingival depigmentation procedure using a diode laser and abrasion method. Methods A group of 20 patients (comprising 4 males and 16 females), aged between 12 and 37 years old, were selected for the study. Inclusion criteria involved patients exhibiting moderate to severe gingival hyperpigmentation on both the left and right sides of the anterior maxillae. Exclusion criteria included pregnancy and lactation, gingival hyperpigmentation associated with systemic conditions or lesions, patients with medical conditions, smokers, and patients under medication associated with hyperpigmentation. The study was designed as a split-mouth study, wherein the upper left anterior sextant of all subjects (from the first central incisor to the second premolar) was treated by abrasion method. Simultaneously, the upper right sextant (from the first central incisor to the second premolar) for the same patient was treated using a 940-nm diode laser. The laser settings comprised a power of 1.2 W and a pulse emission mode with an initiated tip (400 μm) placed in contact with the tissues. Both depigmentation techniques were performed on the same day by a single operator. Results The results indicate a highly significant difference in the mean pigmentation index before treatment and after a 10-month period (p-value = 0.000). No statistically significant differences were observed in the mean pigmentation index between the laser and abrasion methods over the 10-month post-surgery duration. As for the association between patient complexion and re-pigmentation, 7 out of 16 patients with a brown complexion exhibited re-pigmentation, while no re-pigmentation was observed among patients with a fair complexion after a period of 10 months post-surgery. This indicates the presence of a direct relationship between patient complexion and re-pigmentation. Conclusions Based on the study’s findings, both depigmentation methods were effective, with the laser technique notably safer and easier to perform compared to abrasion method. Interestingly, re-pigmentation could occur irrespective of the method used, indicating that individuals with brown or dark complexions had a higher likelihood of re-pigmentation compared to fair-skinned individuals. Considering these results, individuals genetically predisposed to gingival pigmentation should be informed about the potential for recurrence before the procedure, as sustained outcomes might not be guaranteed.

Abstract Background: The primary purpose of this study is to determine the effect of Caries resin Infiltrant (Icon) on the shear bond strength of metal orthodontic brackets using three adhesive systems. Materials and methods: Sixty-six extracted sound upper first premolars tooth were selected. The collected teeth were divided equally into three groups: Gren gloo, (Italy), Light bond, (USA) and Enlight ( Italy). Each one contains twenty-two teeth, which were bonded using the bonding adhesive. Half of them were manipulated with ICON and half of them without ICON. Statistical analysis was performed including t-test, ANOVA test and Tukey’s HSD test. Result: After comparison among all groups with ICON, all groups (Gren gloo vs. Light bond, Gren gloo vs. Enlight & Light bond vs. Enlight) had a significant difference. After comparison among all groups without ICON, two of them had a significant difference which was (Gren gloo vs. Light bond & Light bond vs. Enlight) while the other group (Gren gloo vs. Enlight) showed a non-significant difference. Conclusion: The application of the caries infiltrant following 37% phosphoric acid etching on sound enamel prior to orthodontic bonding could be an alternative to be used as an additional preventive measure against WSL formation. It was concluded that the surface infiltrated by Icon (DMG) did not interfere negatively on the bond strength to the resin composite

A harmonious soft tissue profile, as an important treatment goal in orthodontics, is sometimes difficult to achieve, partly because the soft tissue overlying the teeth and bones is highly variable in its thickness. These variations result not only from imbalance of the dental and skeletal structures but from individual variations in the thickness and tension of the soft tissues. Objective: To investigate the relationship between maxillary occlusal plane inclination and soft tissue harmony of the face in different sagittal skeletal malocclusions. Material and Methods: The study was a cross-sectional observational study. Lateral cephalometric x-rays of 160 individuals were collected from the Orthodontic clinic at the Faculty of Dentistry, Beirut Arab University and divided into 4 equal groups based on ANB as a parameter of intermaxillary skeletal relationship: Class I (CI) (0≤ ANB ≤4), Class II division 1 (CII div 1) (ANB > 4 with normal or proclined upper incisors), Class II div 2 (CII div 2) (ANB > 4 with retroclined upper incisors) and Class III (CIII) (ANB < 0). Hard tissue analysis included 1 angular measurement for maxillary occlusal plane (MxOP) inclination. Soft tissue analysis included 2 angular measurements for facial convexity and 3 linear measurements for inter-jaw harmony and 7 linear measurements for soft tissue thickness. Results: There was significant correlation between MxOP angle and facial contour angle, as well a Sn-Pog’ for participants with CI. In CII div 1, there was a significant correlation between MxOP angl and ULA-LLA, as well as chin thickness V. In CII div 2, there was a significant correlation between MxO angle and Sn-Pog’, ULA-LLA, upper lip strain, chin thickness H, and chin thickness V. In class III, there was no significant correlation Conclusion: H angle, facial contour angle, inter-jaw harmony and soft tissue thickness parameters were not always correlated with MxOP angle and this correlation was highly variable between different skeletal malocclusions. Therefore one cannot fully support the existence of a relation between MxOP and soft tissue harmony.

ABSTRACT Purpose: The purpose of the present study was to emphasize the importance of thorough case analysis including all possible diagnostic measures of facial asymmetry prior to formulating an appropriate treatment planning and select the relevant treatment modality. Patients and Methods: Six Patients, of different age and gender groups with severe facial asymmetry and unilateral condylar hyperplasia, were presented. Border line cases with suspected condylar growth (Age 18-25Y) were subjected to SPECT bone scan prior to orthosurgical intervention. The treatment procedure was selected according to: the condylar growth activity, severity of the dentofacial deformity and age of the patient. Some were treated with unilateral ramus osteotomy of the affected condyle, others with bilateral ramus osteotomy with or without genioplasty and the remaining needed bimaxillary surgery (Le Fort I maxillary osteotomy together with mandibular ramus osteotomy. Results: Posttreatment records (Photos, Models, and radiographs) showed marked improvement in facial symmetry and normal occlusal relationship in 3Ds. The patients’ perception about their facial esthetics and functional occlusion was satisfactory. Conclusions: Optimal oro-facial harmony and balance with normal functional occlusion were achieved. Collaboration between the healthcare team was a key factor in realizing treatment goals and patients’ contentment. Keywords: Unilateral condylar hyperplasia; dentofacial deformity; orthosurgical correction

Objective: To present a new standard of care for a complex rare median maxillary cleft and emphasize on the principles that such cases are best treated by interdisciplinary team of specialists with experience in this field. Materials and Methods: A female patient aged 9 years 6 months presented with a median cleft of lip and palate (premaxilla with four anterior teeth were lost), surgical repair was performed at an early age with visible scar. Full clinical and radiographic records were collected and initially analyzed jointly by an orthodontist, implantologist and maxillofacial surgeon. The maxilla exhibited a deficiency in three planes of space. There was an anterior and posterior cross bite with distorted occlusal plane and anterior open bite. Due to loss of basal support, the nose was severely depressed with flat alar bases (loss of nasal cartilaginous support). The clinicians agreed upon a long-term treatment planning started with orthopedic intervention, orthodontic presurgical preparation, alveolar bone grafting, maxillofacial surgery, nasal reconstruction, postsurgical orthodontic care, placement of dental implants, and prosthetic phase. Results: A significant improvement in facial contour was realized. Lower anterior facial height was reduced by 8.3 mm (angular 11.3°); lips became competent at rest and teeth-to-lip relationship created a beautiful smile, alar bases favorably widened improving nasal esthetics. Conclusions: Despite patient and parents’ satisfaction with the outcome, the long duration of treatment (almost 13 years) for a school-aged girl, and the shuttle movement from private practice to another then to hospital were a burden on the family. This calls for establishing medical centers in Lebanon with a well-trained independent craniofacial professional team, in which all members are involved in conducting a joint evaluation (face-to-face group meeting) and negotiate a comprehensive treatment plan. Keywords: Median Cleft Lip and Palate; Multidisciplinary Approach; Maxillofacial Surgery; Postsurgical Orthodontic Care; Prosthetic

Backgrounds: The purpose of this review is to create awareness among educational policymakers that poor global ranking of our higher education institutions necessitates an in-depth search for the possible constraints that hinder their academic progress. The author focused on certain inhibitors formulated in a questionnaire, format to be filled by participants. Methods: The author in this review highlighted the possible inhibitors to the academic process and potential amendments; a brief one-page questionnaire has been distributed to attendees asking them to fill it on-site. Results: 100.0% of the participants need to improve physical and financial resources and 72.5% have to develop their human resources. 62.9% need to recover the setting of their educational standards. 62.7% agree about the need to eradicate favoritism from their educational level 60.8% have to develop their citations per published paper. 52.9% have to improve the ratio of full-time faculty/ number of student enrolled 51.0% suffers from inequalities in access to higher education. 49.0% agree about the need to improve their attitude towards internationalization. 37.25% need to reform clear policy and guidelines for their faculty and are not satisfied with the non-alignment between information, technology, and higher education institutions. Conclusions: Research analysis and objective judgment of the outcome were hereby presented. The governmental and institutional decision-makers will be informed about the possible inhibitors of our academic progress as perceived by educational experts and how could we all participate in minimizing their consequences.