about scientific federation · 2016-04-17 · since dental implant has been applied as an...

ABOUT SCIENTIFIC FEDERATION

WHO WE ARE?

- Albert Einstein

WHAT WE DO?

WHY SCIENTIFIC FEDERATION?

FOR ATTENDEES

SCIENTIFIC FEDERATION MISSION

SCIENTIFIC FEDERATION VISION

ASSOCIATIONS/COLLABORATIONS

Upcoming Conferences

World Congress and Expo on

Dental & Oral DiseasesApril 18-20, 2016, Dubai, UAE

SCIENTIFIC FEDERATION UPCOMING CONFERENCES

International Congress & Expo on Biotechnology and Bioengineering September 26-28, 2016 Los Angeles, USA

Global Summit on Obesity & Diet Management September 26-28, 2016 Los Angeles, USA

World Congress & Expo on Dementia & Neuroscience September 26-28, 2016 Los Angeles, USA

Global Congress & Expo on Materials Science & Nanoscience October 24-26, 2016 Dubai, UAE

World Conference & Expo on Petrochemistry & Natural Resources October 24-26, 2016 Dubai, UAE

World Congress and Expo on Immunology October 24-26, 2016 Dubai, UAE

World Summit and Expo on Food Technology & Probiotics November 21-23, 2016 Dubai, UAE

International Conference on Biopolymers & Polymer Chemistry November 21-23, 2016 Dubai, UAE

Global Virology Congress & Expo November 21-23, 2016 Dubai, UAE

2nd Global Nanotechnology Congress and Expo December 01-03, 2016 Las Vegas, USA

2nd World Congress and Expo on Oncology & Radiology December 01-03, 2016 Las Vegas, USA

2nd World Congress on Nursing & Healthcare December 01-03, 2016 Las Vegas, USA

2nd Global Summit and Expo on Dental & Oral Diseases March 27-29, 2017 Kuala Lumpur, Malaysia

2nd World Congress & Expo on Pharmaceutics & Drug Delivery Systems March 27-29, 2017 Kuala Lumpur, Malaysia

Global Conference and Expo on Vaccines Research March 27-29, 2017 Kuala Lumpur, Malaysia

Supporting Organizing CommitteeGiath Gazal Taibah University, Saudi Arabia

Shaik Mohiuddin Al Noor Hospital Satellite Clinics Abu Dhabi, UAE

Sylvain Gagnon Université de Montréal, Canada

Rosa Carrieri Rossi São Paulo federal University, Brazil

Anas Al Mulla Director of GCC Affairs Dubai, UAE

Richard Brookshaw Royal College of Surgeons of Edinburgh, UK

Gabriele Edoardo Pecora University of Siena, Italy



Keynote Forum Day 1



The Microbiome and the Future of Home Oral Care

What we are learning about the microbiome is changing how we approach prevention and treatment in dentistry. The story begins from the point of view of a bacterium and what we know about how that

are brought about as we learn more about the microbiome. We close with a consideration of changes in standards of professional dental hygiene and home oral hygiene care.

James L. RatcliffRowpar Pharmaceuticals, USA

Biography :



Effective oral rehabilitation for elderly-disabled patients with

innovative dental treatment modality

The change of treatment paradigm for elderly patients

Since dental implant has been applied as an artificial root for a replacement of tooth in edentulous site,

treatment planning for prostheses has been significantly changed. When there was no alternative but to

employ removable denture on the distal extension of partial edentulism in the past, dental implants have

been a revolutionary tooth-replacement option for those patients. If dental implants are placed on the partial

edentulous site, they will alter the conventional treatment method(A,B) for removable partial denture and

eventually evolve into a new treatment paradigm(C,D) that natural teeth and implants co-exist in the same

oral cavity. The term “Universal design” refers to the design that can be used for all. Barrier-free designed

device, facility, and equipment can be readily used by non-disabled people as well as by disabled people.

Universal design in device, facility, and equipment can be accessed by everyone without difficulty regardless

of disability.

Smart Loading Protocols : The scientific evidence for ‘immediate loading’ in implant dentistry except on

partially edentulous maxilla is sufficient. But, in some of clinical reports, immediate loading even in posterior

maxilla sometimes show good results under limited conditions as follows, Utilize micro-rough surface

treated implants, Maintain around 30~55Ncm of insertion torque on implant surgery, Confirm the implant

bed of at least 5mm remaining bone thickness vertically, when cortical bone fixation technique(bicortical

fixation) with sinus floor elevation is applied, In only those cases that primary stability effect is expected,

which depends on pure physical force and no micro-movement what so ever, during 1 week post-

insertion and etc. immediate loading by connecting immediate functional restorations is possible.CAD/

CAM technology:Computer assisted design (CAD) and computer assisted machining (CAM) have been

gaining increasing use in implant dentistry over the past 10 years. Continuous improvements to CAD/

CAM technology over this time, has started to challenge the technique of fabricating implant prostheses and

abutments using conventional methods. The purpose of this presentation is to answer the focused question:

“How do CAD/CAM implant prostheses in patients with missing teeth, who have one or more dental implants,

perform compared to conventionally fabricated implant prostheses, when assessing aesthetics, complications

(biologic and mechanical), patient satisfaction and economic factors.” Magnetic attachments As technology

advances, magnetic attachments are also improving with continuous researches and experiments operated

by the clinics and researchers today and are clinically proven for its excellence. Moreover, Asian Universities

from South Korea, Thailand, Singapore, Hong Kong, Taiwan, China, and Japan are cooperating to work

for magnetic attachment in an organization called, International Research Project of Magnetic Dentistry

(IRPMD) and within this organization there has been a variety of international conferences were held to

earn a substantial position in all the dental fields especially for the geriatric/disabled people in dentistry.

Richard LeesungbokKyung Hee University, South Korea



Biography :

magnetic effect to bone formation around dental implants. He is also doing many

Abstract

The basic objectives of orthodontic treatment are based on the stability of the upper and lower incisors. The

upper incisors should be positioned parallel to the facial growth axis and lower incisors should be placed in

a equilibrium position with the surrounding muscles.

We calculate the torques that we introduce in the upper and lower incisor brackets in order to achieve these

objectives. So we have a specific working protocol for each patient: we calculate the individualized torques.

Stability on the end of the orthodontic treatment

Jose Duran Von ArxUnivesity of Barcelona, Spain

Biography :



Innovative Use of Laser in Dentistry-New Frontiers of

Ultrafast Laser

Nowadays Laser is routinely used for interventions of hard and soft tissues in clinical dental practice.

Its major use in periodontology is coupled with non-surgical and surgical periodontal therapy resulting

in successful periodontal healing. Application of laser in oral hard tissues seems to open new frontiers

especially in restorative dentistry. Some of the advantages of dental restoration through laser therapy include

analgesic effects, conservative cavity preparation and reduction of hypersensibility. Recently the clinical

potential of Ultrafast Laser in medical treatment has begun to be realized with major clinical adoption to

ophthalmic application. In addition to ablation of soft tissues, Ultrafast Lasers have found some applications

in ablation of teeth. Few protocols have been proposed and to-date all present limited degree of clinical

acceptance. New ongoing research on use of Ultrafast Lasers indicates increased capacity to avoid pain and

patient discomfort. Sintering effect of Ultrafast Laser on new restorative materials present the most exciting

and promising capacity that might become the new gold standard of dentine and enamel restoration.

Felice Roberto GrassiUniversity of Bari, Italy



Biography :Dr. Felice Roberto Grassi graduated in Medicine and Surgery in 1979 at the University

of Bari. He has specialized in Dentistry in 1984 PhD in Orto-sulfonate-rhino-

stomatognatodonzia at the Department of Dentistry, University of Bari. In the year

2002 he was associate professor at the University of Bari and holder of the chair of

Periodontics and Surgery Special Odontostomatology CLSOPD at the University of

Bari. Since 2004 he was professor at University of Bari CLSOPD. In the year 2004 he

was appointed as director as Department of Dentistry and Surgery at the Faculty of

Medicine and Chinirgia University of Bari. Director of the Postgraduate Course in

Periodontal Surgery and Implantology and Professor since 2002 of the Dental Clinic at

the School of Specialization in Maxillofacial Surgery dell ‘ University of Bari. Since 2001

Head of the Operational Simple Periodontology and Implantoprotesi at the hospital

“Policlinico Hospital Consortium” company of Bari. Active member of the Italian

Society of Periodontology and member of European Society of Periodontology. Socio

Honorary Dental Hygienists Italian. Professor at the Specialization in Implantology

and Periodontology courses at the Universities of Naples, Chieti, Genova, San

Raffaele Hospital in Milan and Foggia. Coordinator of the PhD Program in Applied

Biotechnologies at Sciences Odontostomatologiche.Coordinatore PRIN 2005-07

(research project of national interest on stem cells derived from dental pulp) .Autore

of over 100 national and international scientific publications and more than ten of

published textbooks from different publishing houses. Speaker at several national and

international congresses.

Clefts involving the lip and/or palate (CLP) or isolated clefts of palate (CP) are the commonest congenital

anomaly to affect the craniofacial region in human. They represent a complex phenotype and reflect a failure

of the normal mechanisms involved during early embryological development of the face.

A recent report by Grosse and colleagues (2009) noted that team-oriented care for individuals with

Clefts involving the lip and/or palate (CLP) or isolated clefts of palate (CP) requires interdisciplinary

team. The principal role of the interdisciplinary team is to provide integrated case management to assure

quality and continuity of patient care and longitudinal follow- up. Each patient seen by the team requires

comprehensive, interdisciplinary treatment planning to achieve maximum habilitation with efficient use of

parent and patient time and resources. Infant feeding must be addressed; later speech must be dealt with in

a timely manner, seeking every opportunity to enhance the development of normal speech. Another major

concern is esthetics; significant goals of the team include maximizing esthetic results and also facilitating the

development of the orofacial complex.

The Orthodontic care for children with cleft lip and palate

Eman AlnamnakaniPSMMC, Saudi Arabia



Biography :

Eman Alnamnakani is Consultant Orthodontist in Prince Sultan Military Medical

City (PSMMC), Program Director in Saudi Orthodontic Board in (PSMMC), Head of

Clinical Cases Review Committee in Saudi Orthodontic Board, Head of Cleft Lip and

palate unit in PSMMC. Eman received Bachelor of Dental Surgery from King Saud

University in1997, Clinical Certification in Orthodontics from King Saud University

in 2003, Master degree in dental science in 2004, Saudi Board in Orthodontics in 2009,

and Diploma of Membership in Orthodontics in the Royal College of Surgeons of

Edinburgh in 2010.

Technology and Expanded Applications of Dental

Implantology as part of comprehensive treatment planning.

The last two decades have seen huge shifts in the application of dental implantology as it relates to routine dental

factors can now predictably create close to ideal recipient sites prior to implant placement and are determined by the

this momentum that has been gaining traction worldwide.

Rudy M. Wassenaar University of Amsterdam, the Netherlands

Biography :



Dental Public HealthDental therapeutics and pharmacologyOral radiologyPediatric Dentistry Oral and Maxillofacial Surgery

Session 1

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Appropriate antimicrobial use, overuse these agents, and

optimizing use

Geraldo Batista de Melo

Federal University of Uberlandia, Brazil

Surgeries performed in retained third molars, in the oral cavity and other, occur in the contaminated

field, bringing the post-operative problems such as pain, bleeding, discomfort, swelling, infection,

trismus, and inactive days. The aim of this study was to evaluate the differences between conventional

medication and topical delivery antimicrobials. A split half mouth, crossed study “in vivo” was performed

on patients of Hospital Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil, to evaluate pain,

bleeding, discomfort, swelling, infection, trismus, and inactive days. We selected 20 patients, which agreed

with the research and signed an informed consent term, according to the Ethics Committee in Research.

Besides that, investigate the local effect of 10% doxycycline and 1% alendronate combined with poly(lactic-

co-glycolic acid) (PLGA) on bone repair on rats. Additionally was performed sinus lifting the patient and

the installation of two implants supporting Schneider membrane to subsequently apply the loads in patient

with history in renal impairment. After consulting nephrologist was recommended not using antibiotics and

conventional anti-inflammatories avoid overloading the patient’s renal function. Doxycycline has been shown

to improve wound healing, to increase osteogenic mediators, and to inhibition and down-regulation of matrix

metalloproteinase. The benefits include the limited potential for systemic absorption and toxicity, reduced

volumes of antibiotic use, and, possibly, less potential for the development of antibiotic resistance.

Biography :Graduated in Dentistry from the University of Uberaba (1977), Specialist in Microbiology from PUC-BH (1981), master’s degree in Genetics and Biochemistry at the Federal University of Uberlândia (1996) and Ph.D. in Genetics and Biochemistry at the Federal University of Uberlândia (2003) . He is currently associate professor at the Federal University of Uberlândia. He has experience in the field of Medicine and Dentistry, focusing on Infection and Hospital Epidemiology, acting on the following topics: antimicrobials, nosocomial infection, bacterial resistance, biofilm and bacterial growth.

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Effect of Implementing an Oral Care Protocol on the

Incidence of Ventilator Associated Pneumonia among

Mechanically Ventilated Patients at Mansoura University

Hospital

Karima Elshamy

Mansoura University, Egypt

Introduction: Mechanically ventilated patients are at the highest risk for the second most common

nosocomial infection, pneumonia. Oral hygiene is considered basic and potentially essential nursing

care, bad oral hygiene increase oropharyngeal colonization with pathogenic organisms contributes to the

development of ventilator-associated pneumonia in intensive care units.

Aim of the Study: This study was conducted to evaluate the effect of implementing an oral care protocol

on the incidence of ventilator associated pneumonia among mechanically ventilated patients at Mansoura

Emergency Hospital.

Materials and Methods: A quasi- experimental design was used in this study. The study subjects includes

two groups Group I, consisted of 40 patients received routine oral care (control group) Group II, includes 40

patients received oral care protocol (study group). Tools of the study consist of two tools, the first tool was

Patients’ assessment sheet of VAP, and the second tool was oral assessment form for assessment of oral health

condition.

Conclusion: implementing the oral care protocol reduce the incidence of VAP to 27.5% among mechanically

ventilated patients.

Recommendations: 1- Replication of the study using a large probability samples acquired from different

geographic areas. 2- A longitudinal study should be designed to determine the long term effect of the

developed oral care protocol over a large period of time. 3- An educational program should be established for

nurses caring for mechanically ventilated patients in the ICUs.

4-Written oral care should be initiated in the ICU.

Biography :Dr. Karima Elshamy has a doctorate degree in nursing science from Cairo University, Egypt (DNSc). She is Prof. of Medical

Surgical Nursing and Head of Gerontology Nursing Department, Faculty of Nursing, Mansoura University, Egypt. She

was a head of Critical Care and Emergency Nursing Department, Faculty of Nursing, Mansoura and Fayoum University

Egypt 2011-2012. She represented AORTIC Nursing of North Africa since 2009 – 2011, and from 2011 - 2013 she was

AORTIC Vice President of Oncology Nursing, and now she is AORTIC Vice President of North Africa. Dr. Karima is a

member of AORTIC Education and training committee. Dr. Karima is a member of the Editorial Board of the Journal

of Cancer Policy. She is Accreditation Reviewer in Ministry of health, Egypt from 2004 till now and shared in reviewing

and accreditation of many health agencies in Egypt. She has more than eighteen years in teaching experience for under

and postgraduate nursing students. Dr. Karima Elshamy is a trainer of academic staff of Mansoura University, Egypt. She

is also a trainer for all nursing categories all over Egypt and outside Egypt. She is a founder and executive director of the

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Egyptian Society for Promotion of Women’s Health (ESPWH). Also she is an expert and consultant of infection control

and has extensive experience in open heart and chest surgeries. Prior to her academic work, she has worked as a manager

of cardiothoracic intensive care units Cairo University, Egypt for more than 15 years and has extensive experience in

open heart and chest surgeries. Dr. Karima Elshamy ‘focus work and research is: the prevention and control of diseases

through awareness and early detection programs especially for cancer, cardiac, hypertension and occupational diseases,

also for infection control, quality and accreditation. Dr. Karima Elshamy has high hopes for her country, as well as all

Africa and plans to concentrate on public health and oncology health program management at Egypt. The major health

challenges facing Egypt as well as all Africa are preventable diseases such as cancer diseases especially in rural areas

where many people lack of access to medical care and health information due to financial and culture restrains and lack

of health education programs. Most health policy mainly focuses on treatment; however, Dr. Karima Elshamy envisions

that she and other health personnel can improve health outcomes especially rural women through comprehensive health

awareness, early detection and promotion programs.

4



Autophagic cell death is a key event induced in tooth

pulp cells by local anesthetics

Heng Zhuang

Bybo Dental Group,, China

Tooth pulp cells are essential for tooth development, repair and regeneration. In addition these cells

have been recently identified as an important stem cell source. Local anesthetics are widely used in

the treatment of young permanent teeth. These agents have been suggested to interfere with human

tooth development and induce tooth agenesis through unknown mechanisms. It is therefore important to

study their effects on tooth development and pulp cell health. We tested five common local anesthetic drugs:

three containing articaine (Ubistesin, Ubistesin forte or Septanest), one containing mepivacaine (Scandonest)

and one containing lidocaine were tested on pig mandibles to define the local concentration of the drugs

through nerve block and local infiltration simulation. Primary cells isolated from young human permanent

teeth were used to study the effects of the agents. The cellular processes and energetics were evaluated and

associated signaling pathways were analyzed. Rescue experiment was performed by blocking autophagy

pathway using V-Atpase specific inhibitor. Through nerve block local anesthetics could penetrate into the

developing third molar tooth and remain at a high concentration even after 16 hours in high concentration

while local infiltration only affected the superficial layer of first molar tooth pulp cells and the agents were

eliminated after 2 hours. Significant levels of autophagy were induced in the cells upon drug treatment starting

as early as 2 hours, and cell proliferation was inhibited, but differentiation and apoptosis were unaffected.

Induction of autophagy was shown by increased accumulation of LAMP-1- and LC3-positive autophagic

vacuoles. Molecular pathway profiling suggested that LC3II is one of the earliest molecules induced by the

agents and transcriptional factor p62 is the only common down-stream target identified for all the drugs

tested. Interestingly mitochondrial functions were increased within the first 8 hours and only diminished

after 16 hours when high concentration of the drugs was applied. In addition, proton leak was constantly

identified. Bafilomycin A1, an autophagy inhibitor, at a defined concentration could rescue local anesthetics

induced cell growth arrest except for the condition when high dosage drugs were applied for more than 16

hours. Our results show for the first time that local anesthetics can trigger autophagy in young permanent

tooth pulp cells, which may induce side effects. In particular, this kind of autophagic cell death might affect

tooth development and tissue regeneration.

Biography :Heng ZHUANG is head of department of medical administration in Bybo Dental Group since 2015. During 2006-2015

she was associate chief clinical physician in Peking University School and Hospital of Stomatology. She received a M.S

from West China University of Medical Sciences in 2000 and Ph.D. from Sichuan University in 2003. She worked as a

postdoc in College of Stomatology, the Fourth Military Medical University during 2004-2006 and a visiting scientist in

University of Lausanne, Switzerland in 2011, and in Peninsula Dental School, Plymouth University Peninsula Schools of

Medicine & Dentistry during 2014-2015

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Knowledge and Attitude towards Antibiotic Use among

Public Attending USIM Dental Clinic, Malaysia

Haslinda Ramli

Universiti Sains Islam Malaysia, Malaysia

Antibiotics are among the most utilized drugs in Malaysia. Frequent and incorrect use of antibiotic had caused the emergence of antimicrobial resistance bacteria. Information on public knowledge and attitudes towards antibiotic plays a crucial role in the

success of future educational program to combat antimicrobial resistance. This study aimed to assess the attitude and knowledge among dental patients towards antibiotic treatment which could serve as baseline data for future studies regarding antibiotic use in dentistry. A survey involving 350 respondents attending Universiti Sains Islam Malaysia (USIM) Dental Clinic was conducted using a self-administered questionnaire from September 2014 to October 2015. Nearly 70% of the respondents had a moderate level of knowledge. 67.1% respondents incorrectly thought that antibiotics can be used to eradicate viral infection and 57.8% respondents were aware that overuse or prolonged use of antibiotic will induce bacterial resistance to antibiotic. With regards to attitude, 53.9% did not consume the prescribed antibiotic according to instruction and 61.7% respondents experienced left-over antibiotic. Gender and age were significantly associated with knowledge, whereas level of education and income were found to have significant association with attitude. Specifically targeted educational invention programs are needed to promote prudent use of antibiotics among public. Keywords: antibiotic use, knowledge, attitude, dental, Malaysia.

Biography :Dr Haslinda Ramli qualified in dentistry from University of Malaya in 1999 and awarded of Master Dental Surgery in Periodontology by The University of Hong Kong in 2010. She is currently a lecturer in Periodontology at Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM) and involved in research, clinical practice, teaching undergraduate and faculty administration. Her research interest covered clinical dentistry, periodontology, microbiology and molecular, quality of life and interdisciplinary area.

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Taste Perception - A New Risk Determinant for Dental

Caries

Abrar Alanzi

Kuwait University, Kuwait

Dental caries remains the most common chronic infectious disease of childhood. The role of diet as a

direct cause of dental caries has been extensively reported. The high sugar intake reflects a preference

for sweet substances. Differences in taste perception would influence the individual differences in

taste preferences and food selection? This oral presentation will cover a new knowledge about the influence

of taste sensitivity on the dental caries experience and will highlight its role in identifying who are at high

caries risk.

Biography :Abrar Alanzi is a specialist of pediatric dentistry and works as an assistant professor at Department of Preventive and Developmental Sciences, Kuwait University, Kuwait, where she has been since 2013. She completed her postgraduate studies in Pediatric Dentistry and received M.S. from University of Maryland Baltimore, Maryland, USA. She worked as a clinical instructor in Pediatric Dentistry at the University of Maryland Baltimore for the year 2011-2012. She is a board-certified by the American Board of Pediatric Dentistry and an active member of American Association of Pediatric Dentistry (AAPD), International Association of Pediatric Dentistry (IAPD), and International Association for Dental Research (IADR).

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Interrelationship between periodontics and adult

orthodontics

Zamira Kalemaj

University of Turin, Italy

Over the past two decades the number of adult orthodontic patients has increased markedly. Apart

from establishing good occlusion and improving dental and facial aesthetics, one of the major

objectives of orthodontic therapy is enhancement of periodontal health. Unfortunately, in everyday

orthodontic practice insufficient emphasis is placed on periodontal diagnosis prior to orthodontic therapy

and to periodontal health control throughout the therapy. The absence of periodontal inflammation during

orthodontic treatment along with patient’s compliance can provide the most satisfactory results and long-

term stability. We present our step-by-step approach on treatment of periodontally compromised patients,

through several detailed clinical cases. Furthermore we summarize scientific evidence and clinical expertise

on different techniques aiming acceleration of orthodontic therapy, leading to conclusions of high relevance

in terms of effective and efficient therapy for both clinician and patient.

Biography :Zamira Kalemaj obtained her degree as a dentist in 2010 and received her PhD in New Technologies Applied to Orthodontic Sciences at the University of Turin in 2015. She has completed a scientific master in Epidemiology and Statistics at the University of Turin and her research work is mainly focused on designing and conduction of clinical trials and systematic reviews. She was a first generation ERAWEB Erasmus PhD student. She also currently serves as teaching and clinical consultant at the division of orthodontics at the University of Turin and University of Bari. She cooperates in several national and international multidisciplinary research projects focused on new technologies and new dental materials

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Localization of supernumerary teeth in the anterior

region of the maxilla

Sreekanth Kumar Mallineni

Clinic Head and Consultant Paediatric Dentist, India

Supernumerary teeth are defined as “any tooth or odontogenic structure that is formed from a tooth germ

in excess of the usual number for any given region of the dental arch”. They may be single or multiple,

unilateral or bilateral in distribution, can occur in both dental arches, and either in the primary mixed

or permanent dentitions. The mesiodens are the most commonly occurring supernumerary teeth followed

by mandibular premolars which are the supernumerary teeth of the supplemental type. Males are more

commonly affected than females, at a ratio of 2:1. Several hypotheses have been proposed to explain the

occurrence of supernumerary teeth, but their aetiology still remains unclear. The prevalence of supernumerary

teeth ranges from 1.5% to 3% in the general population with a predilection to the mongoloid racial group. The

supernumerary teeth may cause several complications such as, delayed tooth eruption, failure of eruption of

the permanent successor tooth, a midline diastema, displacement or rotation of the adjacent teeth, crowding,

malocclusion and dentigerous cyst formation. Early diagnosis and proper treatment plan is very essential.

Clinical diagnosis is the first and most important aid in the diagnosis of an impacted tooth. Clinical localization

includes inspection and palpation, while radiographic localization is based on different combinations of

radiographs. Localization of supernumerary teeth plays a major role in diagnosis and treatment planning,

especially if surgical intervention is needed. Although it is obvious that early intervention can potentially

prevent later complications, several authors have anecdotally suggested that this approach is hazardous due to

the possible risk of damage to the developing tooth germs. Location of supernumerary teeth can be confirmed

by different imaging techniques. Localization of an un-erupted tooth is based on a combination of clinical and

radiographic assessment. The more exact the localization of supernumerary teeth the less invasive the surgical

procedure, therefore, the purpose of this paper was to conduct a narrative review of the available literature and

to identify the best technique for localization of supernumerary teeth. A number of localization techniques

have been reported in the literature for impacted teeth by several authors. Only a few techniques were used

for the localization of supernumerary teeth; however, there is no evidence in the literature to identify the most

accurate technique for the localization of the supernumerary teeth.

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Epistaxis, nasal obstruction and unilateral facial pain due

to a ectopic tooth, a rare condition.

Samer Malas

King Hamed University Hospital, Bahrain

The ectopic eruption of a tooth within the dentate region of the jaws is often noticed in routine clinical

practice. But the ectopic eruption into a non-dentate region is rare, especially in area of the maxillary

sinus. The maxillary sinus is a non-dentate region to accommodate such ectopic eruptions of teeth.

Early surgical intervention for the removal of ectopic tooth/teeth along with enucleation of the associated

cyst such as a detigerous cyst if present is the treatment of choice. Here we report a patient who was referred

because of chronic mucoprulent discharge and epistaxis. This condition was odontogenic in origin caused by

an ectopic tooth near the sinus ostium but had no dental complaints.

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Single VS multiple visits RCT

Mohammed Mashyakhy

Jazan Univesity, Saudi Arabia

Conventional Root canal treatment (RCT) is a common procedure in dentistry. It normally requires

multiple visits.

Recently, it has been recognised that root canal treatment can be successfully carried out within a

single visit, especially for the primary treatment of vital pulp or asymptomatic necrotic pulp. Single and

multiple visits RCT both have their indications and contraindication. There is scientific, practical and financial

justification for either one. A single-visit treatment completed with final filling in the same treatment session

as the instrumentation procedure reduces total time for the treatment and travel time for the patient has good

patient acceptance and is good for practice management.

So, here we will discuss the rationales and benefits for both choices for the sake of providing an efficient and

up to the standard service to the patient by choosing one of the approaches.

Biography :Mohammed Mashyakhy is Assistant Professor in Endodontics and Vice Dean for Clinical Affairs at College of Dentistry,

Jazan University, where he joined the Endodontic Department since 2009. Dr.Mashyakhy received his Bachelor of Dental

Surgery from King Saud University, KSA in 2006, and then he achieved his MSc in Oral Sciences from Queen Mary

University of London 2009. He spent 3 years in the United States studying clinical Endodontics to get two certificates: 1)

Advance Program in Endodontics for International Student from New York University 2012, and, 2) Residency Program

in Endodontics from The University of Southern California 2014. His Diplomate Status as an American Board of

Endodontics fellow was achieved recently on 2015. Dr.Mashyakhy enjoys teaching undergrad, post-grad students and

carrying hands-on workshops using Endodontics Microscope to spread knowledge and awareness of Endodontics current

concepts and practice.

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Cone Beam Computed Tomography (CBCT) and

computer guided implant surgery From virtuality to

reality

Khaled Ekram

Cairo University, Egypt

Cone Beam Computed Tomography (CBCT) is now very widely accepted and is already in use in dental

practice all over the world. This presentation will demonstrate how this modality can provide the

dentist with useful diagnostic information which can be integrated with other advanced modalities to

produce computer generated surgical guides that can allow the operator to surgically apply the predetermined

treatment plan for different surgical and prosthetic applications that are difficult or even impossible to obtain

by conventional methods.

In this presentation, computer guided implant surgery will be discussed in details from A to Z, starting from

the CBCT scanning protocol which differs according to the type of support from which the computer generated

surgical stent will get its support till the drilling protocol and types of drilling systems and techniques used

in these types of surgeries. Also in this presentation the types of computer generated surgical stents will

be highlighted. Surgical stents differs according to the type of support and also according to the drilling

technique, Moreover the precautions that should be made during the surgical protocol will be discussed

in details as well as the differences between the conventional surgical protocol and the computer guided

methods. Finally, other applications of digital dentistry will be mentioned briefly

Biography :Khaled Akram has completed his Graduation and PhD at Cairo University. He is also a member in European association

of dento-maxillofacial radiology ( EADMFR) and also associated with International association of dentomaxillofacial

radiology ( IADMFR). Dr. Khaled Akram is currently working as assistant professor in the department of Oral and

Maxillofacial Radiology at Cairo University, Egypt.

EndodonticsOrthodonticsProsthodontics Periodontology Oral Medicine

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Therapeutic Strategies to Treat Periodontitis in Diabetes

Jake Chen

Professor and Director, Division of Oral Biology, Tufts University, Boston, MA, USA

Adiponectin is an adipokine that sensitizes the body to insulin. Low levels of adiponectin have been

reported in obesity, diabetes and periodontitis. In this study we established experimental periodontitis

in male adiponectin knockout and dietinduced obesity mice, a model of obesity and type 2 diabetes,

and aimed at evaluating the therapeutic potential of adiponectin. We found that systemic adiponectin infusion

reduced alveolar bone loss, osteoclast activity and infiltration ofinflammatory cells in both periodontitis

mouse models. Furthermore, adiponectin treatment decreased the levels of proinflammatorycytokines in

white adipose tissue of diet-induced obesity mice with experimental periodontitis. Our in vitro studies also

revealed that forkhead box O1, a key transcriptional regulator of energy metabolism, played an important

role in the direct signaling of adiponectin in osteoclasts. Thus, adiponectin increased forkhead box O1 mRNA

expression and its nuclear protein level in osteoclast-precursor cells undergoing differentiation. Inhibition of

c-Jun N-terminal kinase signaling decreased nuclear protein levels of forkhead box O1. Furthermore, over-

expression of forkhead box O1 inhibited osteoclastogenesis and led to decreased nuclear levels of nuclear

factor of activated T cells c1. Taken together, this study suggests that systemic adiponectin application may

constitute a potential intervention therapy to ameliorate type 2 diabetes-associated periodontitis. It also

proposes that adiponectin inhibition of osteoclastogenesis involves forkhead box O1.

Biography :Dr. Jake (Jinkun) Chen is Professor and Director of Division of Oral Biology at Tufts University School of Dental Medicine

in Boston. He is also a Professor in the Dept. of Anatomy and Cell Biology at Tufts School of Medicine and Sackler School

of Graduate Biomedical Sciences. He received his dental training from both Shanghai Jiao Tong University (DDS) and

Tufts University (DMD). Dr. Chen has also a Masters degree of Dental Science and an Oral Pathology Certificate from the

University of Connecticut. In 1993 he obtained his PhD from the University of Toronto in Canada. Dr. Chen became a

tenured professor and licensed dentist in 1998. He was selected as a Fellow of American College of Dentists in 2011. Dr.

Chen is the Guest Professor at seven prominent foreign universities. Dr. Chen has been supported by National Institutes of

Health (NIH) RO1 grants since 1994. He has served as a grant reviewer for NIH and CNSF in the past ten years. Dr. Chen

has published over 70 SCI papers in peer-reviewed journals. His research laboratory has focused on the following four

areas: 1. Gene expression and regulation in bone development and formation using transgenics, lentiviral infection, signal

transduction pathway, small RNA techniques and epigenetics; 2. Using adult stem cells and induced pluripotent stem cells

(iPSCs) to engineer and regenerate oral and craniofacial bone tissues; 3. Translational studies including treatment for bone

disorders in diabetic and obese patients, bone metastasis of cancer and osseointegration of bone implants; 4. Application

of nanomaterials in cell based gene therapy. Over 40 students, post-doctoral fellows and visiting scholars have worked in

Chen Laboratory. Dr. Chen has been invited to lecture at universities and industry companies in the US and globally. His

speeches have been well received by audience.

14



Implant Borne Dental Rehabilitation During Childhood

in Case of Ectodermal Dyplasia : 2 Patients

Christian Paulus

SEL Paulus-Richard, France

The ectodermal dysplasias are rare diseases with hypodontia, hypotrichosis and hypohidrosis. The

subject’s life is considerably constrained and this from an early age, with major difficulties for the

integration and acceptance of conventional prosthetic occlusal rehabilitation.The use of implants is an

integral part of early treatment, in the regions of stable growth, that is to say symphysis. In two childs of 5 and

6 years we have made implant-borne prosthetic rehabilitation in the maxilla and the mandible. Aesthetic and

social evaluation were positive. We have restored the normal oro-facial functions for the correct development

of skeletal bases. They acted as an external fixator intraoral, stimulating the growth by the function. Our

question was : can we leave a child throughout his childhood and adolescence with a not suitable removable

prosthesis, under the pretext of growth unfinished?

15



The 100% digital orthodontic office

Sylvain Gagnon

Universite de Montreal, Canada

The use of CADCAM makes huge advancement and drastically changes the orthodontic office. The

computer base platform allows you to simulate treatment plan and produce custom made wires,

aligners, retainers, etc.

This unique system greatly improves the end result with a precise and refined outcome. The use of robots and

3D imaging completely changes office routine and organization for the better.

The future is now, get onboard! You don’t want to be cought of guard and left behind!

Biography :Gagnon S. is invited professor at University de Montréal Faculty de Medicine dentaire since 1991. He has a private practice in Montréal Canada. He received is DMD at University de Montréal in 1984 and his orthodontic specialist certificate from the same university in 1991. He is active member of ODQ, AAO, AOQ, NESO, SFODF and AIOF. He develops a expertise in digital orthodontics and CADCAM.

16



Sally Fields Where Are You? Incidence, Onset, and

Management of Bisphosphate-Related Osteonecrosis of

the Jaw (BRONJ) by a novel adjunctive therapy

James L. Ratcliff

Rowpar Pharmaceuticals, USA

Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) is a significant and growing problem in

dentistry which, if poorly managed can result in resection of all affected regions that can include the

maxillary and mandibular arches, as well other bones of the head and neck region. BRONJ is associated

with high morbidity and sometimes even death. Research has shown that the etiology of BRONJ is the

use of anti-resorptive agents such as bisphosphonates and denosumab that can cause inhibition of normal

osteoclastic bone resorption. Today, there are over 122 million active prescriptions of bisphosphanes for the

treatment of osteoporosis alone, and 3 to 7 percent of those taking bisphosphantes will develop MRONJ. Other

aspects that influence the pathophysiology of MRONJ include inhibition of angiogenesis, inflammatory and/

or infectious components, soft tissue toxicity of the anti-resorptive medications, and possibly dysfunction of

the immune system. Several clinicians have recently published cases that successfully treated with the use of a

phosphate-buffer-stabilized 0.1% chlorine dioxide-containing mouthwash. Due to the sporadic incidences of

BRONJ, a clinical trial is difficult to be performed. The results of those case studies will be reviewed and their

implication for research and clinical practice will be discussed.

Biography :James L. Ratcliff is Chairman of the Board and CEO of Rowpar Pharmaceuticals, Inc., Scottsdale, AZ, maker of the Dentists

Choice and ClōSYS brands of oral care products. In 2014, Rowpar received the U.S. Small Business Administration’s

Exporter of the Year Award. From 1989 to 2000, Dr. Ratcliff served as senior research scientist, professor and director,

Center for the Study of Higher Education at the Pennsylvania State University. From 1979 to 1989, Dr. Ratcliff was

professor and program head for higher education at Iowa State University. Dr. Ratcliff is author of 120 articles, books, book

chapters, is co-inventor on over 24 patents and patents pending. He is active member of the Arizona Biotechnology Assn.,

American Academy of Oral and Systemic Health, American Education Research Assn., and the International Association

for Dental Research. He holds a Ph.D. in Higher Education from Washington State University, a M.A. in History from

Washington State University, and a B.A. from Utah State University.

17



Control of oral functions

José Durán von Arx

Univesity of Barcelona, Spain

After codification of oral funcions, we propose a protocol to correct all altered functional aspects.

We use diferent kind of devices using stimulee as a work method. These devices will be the nasal

stimulator, the labial stimulator, the buccal obturator, the muscle relaxant, the antibruxismus device

and the open bite appliance. We will present them with their clinical cases treatments.

Biography :José Durán von Arx studied Medicine at the University of Barcelona (1970) and later Stomatology at the University of

Madrid (1971). Her received his PhD in Medicine and Cirurgy in 1984 from the University of Barcelona. He is currently

Professor and Head of the Department of Orthodontics at the University of Barcelona. He is also the Director of the

Master of Orthodontics of the University of Barcelona since 1991. He was Director of the Orthodontic Department of

Orthodontics on the Children´s Hospital of Barcelona. He is director of the Orthodontic World Institute of Barcelona. He

has written more than 300 articles and has published 4 books in the field of orthodontics, one about “Stimulotherapy in

Orthodontics” (in Spanish). He is the creator of the MFS philososphy: individualized prescription of the Turrin brackets

and stimulotherapy devices and gives courses around the world about his MFS philosophy.

18



Management of supernumerary teeth in children

Sreekanth Kumar Mallineni

Clinic Head and Consultant Paediatric Dentist, India

Supernumerary teeth (ST) are defined as “any tooth or odontogenic structure that is formed from a tooth

germ in excess of the usual number for any given region of the dental arch”. The reported prevalence of

ST ranges from 0.05% to 7.8% in the primary dentition while 0% to 6.7% in the permanent dentition.

Supernumerary teeth may be single or multiple, unilateral or bilateral in their distribution, and can occur

in any region of the dental arch, and commonly seen in anterior part of the maxilla. Despite the proposal

of numerous hypotheses, such as, atavism, dichotomy, hyperactivity, and trauma, the aetiology of ST still

remains unclear. The ST may cause several complications from delayed tooth eruption to cyst formation.

Hence, early diagnosis and proper management plan are considered to be important in growing children

with ST. Nevertheless, appropriate intervention can avoid the possible future complications and can help the

correct evolution of the dentition development. Both clinical and radiographic examinations are considered

essential for the identification of supernumerary teeth. Moreover, it is appropriate to state that early diagnosis

and appropriate intervention can limit, or prevent the occurrence of complications associated with ST.

19



Management of a Horizontally Impacted Lower Left First

Permanent Molar: A Case Report

Catherine Grace F. Orlina

Manila Central University, Philippines

Impaction of the lower first molar is not a common dental problem. It presents a great challenge to both the

orthodontist and the oral surgeon. This case report describes the surgical and orthodontic management

of a horizontally impacted lower left first permanent molar of a 12-year old female patient that presented

a Class II Division I malocclusion. Early surgical removal of all third molars, surgical uncovering with

orthodontically assisted eruption, uprighting of the impacted lower left first permanent molar and a two-

phase orthodontic treatment was performed to achieve successful eruption, space provision and uprighting

of the impacted lower first molar. Correction of Class II malocclusion problem was selected as treatment of

choice. It took two years to upright the impacted lower left molar.

Biography :Dr. Catherine Grace F. Orlina is a graduate of the University of the East College of Dentistry in Manila, Philippines (1987).

She obtained her Masters of Science in Orthodontics at the Manila Central University (2013) where she currently teaches

Orthodontics and Pediatric Dentistry in the undergraduate department. Dr. Orlina is also the Clinical Section Head of

the Orthodontics and Pedodontics Department. She has participated in several local seminars as posterboard presentor

and table clinician. Dr. Orlina has attended various seminars and conferences locally and abroad. Aside from teaching, she

also volunteers in various medical and dental missions in the church and Non government organizations. She maintains

a private practice together with her husband in Manila

20



Use of Polyethylene fibers to restore endodontically

treated teeth - A conservative approach

Seema A. Hussain

Taibah University, Saudi Arabia

Use of Leno weave Ultra high modulus (LWUHM) polyethylene fiber in combination with the bonding

agent into the bed of flowable resin has been shown to increase the fracture strength of root filled

molar teeth. This study was carried out with an aim to evaluate the effect of reinforcement of two

different polyethylene fibers in MOD cavities of root filled premolar teeth using LWUHM polyethylene

fibers (Ribbond) and unidirectional polyethylene fibers (DVA, Dental Ventures of America, Riverside, CA).

Hundred extracted human maxillary premolars were divided randomly into five groups. Group 1 served as

positive control and received no treatment. The remaining samples received root canal treatment and MOD

cavities were prepared. They were divided into four groups; In Group 2, MOD cavities were left unrestored

as negative control. Group 3 was restored with composite, Group 4 &5 with DVA and Ribbond polyethylene

fibers in composite respectively. Finally a compressive force at a strain rate of 5 mm/min was applied using

universal testing machine until the samples fractured. One way ANOVA and post hoc Dunnett D tests were

used at 0.05 significance level. Fracture strength of Group 5 (1372.05±853.00N) was significantly greater

than the other groups except for Group 1 (1575±708.04N). The mean fracture strength for control group

1575±708.04 N was significantly different from those of other groups (P<0.05). Polyethylene fiber reinforced

composites in root filled teeth showed improved fracture resistance when compared to other groups. Ribbond

polyethylene fiber reinforced teeth showed superior fracture strength when compared to DVA polyethylene

fiber reinforced teeth.

Biography :Dr. Seema Abid Hussain is working as an Assistant Professor of Endodontics in College of Dentistry, Taibah University,

and Kingdom of Saudi Arabia since 2011. She has obtained her Masters in Dental Surgery from Datta Meghe institute of

Medical Sciences, Nagpur, India and Bachelor of dental surgery from A. B. Shetty Memorial Institute of Dental sciences,

Mangalore, India. With good academic, clinical and research skills, she has been awarded for high performance in clinical

skills for treating patients in Taibah University.

21



Minimally Invasive Shaping - A New Paradigim in

Endodontics

Andrea Balocco

AB clinic, Italy

The advent of rotary NiTi instruments has dramatically simplified and quickened thepreparation of

root canals, allowing also general practitioners to perform good quality endotreatments, with higher

success rates; nevertheless, vertical root fracture - a seriouscomplication which leads to extraction -

still remains a major cause of long-term failure inendodontically treated teeth.The prevalence of vertical root

fractures remains constant over years, forcing theendodontic specialists to critically rethink their protocols.

Dentin zones playing a strategic role in keeping tooth resistance to masticatory loads canbe preserved by

adopting a new Minimally Invasive approach, involving all the steps ofroot canal treatment: access cavity

design, shaping, cleaning, and root filling.Focusing on shaping, next generation rotary instruments are now

available; their physicaland chemical properties allow the clinician to perform a canal preparation respecting

theoriginal anatomy and saving a great amount of root dentin; thus, turning maybe obsoletethe crown-down

gold rule to generously enlarge the coronal and middle third.The final goal of that new approach is to obtain

a biomimetic canal treatment: adaptingthe preparation to canal shape, not vice versa.

Biography :Dr. Andrea Balocco graduated in dentistry from University of Parma (Italy) in 2009;then, he completed two Master’s Degrees: in Pediatric Dentistry (University of Brescia -Italy, 2011), and in Clinical and Surgical MicroEndodontics (University of Turin - Italy,2014).Since 2012, he works in several private practices of northern Italy, focusing his workexclusively on endodontics under microscope magnification and restorative dentistry.Member of AIE (Italian Academy of Endodontics), SIE ( Italian Endodontic Society) andESE (European Society of Endodontology), currently he is giving lectures and hands-oncourses in endodontics, as a certified trainer for Coltene Italy.His areas of special interest involve dental traumatology; regenerative endodontics;minimally invasive endo-restorative approaches; complex retreatment cases.

22



Photodynamic therapy as a novel treatment protocol for

Periodontitis- An Evidence based approach

Betsy Joseph

King Khalid University, Saudi Arabia

Management of patients with periodontitis of varying extent and severity can be often challenging

and difficult. Scaling and root planing (SRP) still remains to be the gold standard for the non-

surgical treatment of periodontal disease. However, it has been noticed that in some cases, adjuctive

treatment modalities are required to suppress periodontal pathogens and augment the effect of conventional

mechanical treatment. Therefore, photodynamic therapy (PDT) has been suggested as an alternative treatment

modality in managing periodontitis.

Photodynamic therapy (PDT) is a modern approach in dentistry where light of an appropriate wavelength is

used in the presence of a specific photosensitizer (PS) to eradicate target cells selectively. In PDT, the PS binds

to the target bacteria and can be activated by light of a suitable wavelength within the therapeutic window

(630–830 nm). Although PDT is more widely known for its application in the treatment of neoplasms,

PDT shows great potential in the treatment of periodontitis. Various clinical trials have been conducted to

evaluate the effects of PDT as an adjunct in the management of chronic and aggressive periodontitis patients.

While there is still inconclusive data regarding a definitive benefit for PDT along with SRP in the treatment

of periodontitis, its noteworthy that several clinical trials have shown additional clinical, microbiological,

immunological and patient-based benefits when PDT and SRP were given in combination to patients with

periodontitis. This presentation is an evidence-based approach to summarize the results of the available

literature for clinical protocol for application of photodynamic therapy. It is intended to aid the clinicians

and academicians in making evidence-based treatment decisions regarding PDT as a nonsurgical treatment

modality management of periodontal diseases.

Biography :Betsy Joseph is Assistant Professor of the Department of Periodontics and Community Dental Sciences (PCS), King Khalid

University, Abha, Kingdom of Saudi Arabia. She was awarded Ph.D in Faculty of Dentistry Kerala University (India) in

2015 for the doctoral work on photodynamic therapy and laser induced autofluorescence spectroscopy in the management

of chronic periodontitis. She has presented her work in national and international conferences and has published scientific

papers in high quality impact journals. She has over 7 years of teaching experience and is also the author of the upcoming

book “Optical Spectroscopic techniques in the management of periodontitis”.

23



The Holistic Treatment of The Dental Patient Conscious

Sedation According To Giovanni Manani

Marco Capecchi

Padua University, Italy

Dental fear is a universal problem. It was estimated that approximately 25% of patients avoid dental

treatment over the world. Furthermore, population ageing increase the incidence of underlying

medical conditions witch may be exacerbated by anxiety or stress during dental treatment. The aim of

this oral presentation is to describe an integrated method to identify patients with high or very high need of

sedation, according to the “Patient-centred clinical method”. We also describe the conscious sedation technic

used in clinical dentistry according to the Giovanni Manani method taught at the University of Padova.

Biography :Dr Marco Capecchi completed his training in Oral Implantology and in Conscious Sedation and Emergency in Dentistry

at Padua University, Italy.He currently lives and works in Pistoia as private dentist and is mainly engaged in implant

surgery and conscious sedation. He is member of the Associazione Italiana di Narco Odonto Stomatologia as well as the

Associazione Italiana Sedazionisti ODontoiatri.

24



How interactions between oral microorganisms can

shape their behavior in mixed biofilms

Helena Sztajer

Helmholtz Centre for Infection Research,Germany

The oral cavity microorganisms live in biofilm and in dynamically changed sophisticated relationships

in which symbiotic and potentially pathogenic microbiotas coexist in homeostasis and the

communication between them enables formation of successful organization and growth. However,

under certain conditions this homeostasis is disturbed, resulting in sequential changes of population leading

to diseases development. The mostly known biofilms originated oral diseases are caries and periodontitis. The

composition and biological activity of the biofilms microbiotas is shaped by the interactions between individual

members. Streptococcus mutans (Smu), Candida albicans (Ca), Aggregatibacter actinomycetemcomitans (Aa) co-occur in the human oral cavity in supra- and sub-gingival biofilms. In our research we have studied

communication between those microorganisms and analysed their transcriptomes to reveal how those

interactions shaped the biofilm formation and diseases development. Dual species biofilms of Smu/Aa

and Smu/Ca, respectively, grown synergistically in medium mimicking saliva. Induction of sigX, the gene

encoding alternative sigma-factor, controlling Smu quorum sensing (QS) in dual-species biofilms was studied

using a reporter strain of Smu carrying a plasmid with the promoter of sigX fused to the green fluorescence

protein (GFP). Deep sequencing of dual species biofilms mRNA in a time dependent manner revealed

fundamental changes in the transcriptomes in comparison to the mono-culture transcriptomes. The most

abundant transcripts of Smu in mixed Smu-Ca and Smu-Aa biofilms, respectively, belonged to the quorum

sensing regulon sigX and the comS gene encoding the XIP pheromone of Smu. Whereas, QS related genes of

Aa were repressed. S. mutans virulence has been changed when grown in mixed biofilm. Higher expression

of bacteriocins genes was observed and polysaccharides synthesis shifted by Smu when grown with Ca from

the extracellular polysaccharides (EPS) towards the intracellular (IPS) storage polymer glycogen. However,

the majority (20%) of transcriptional activity of Aa when grown with Smu was devoted to the tad locus

responsible for the production of adhesive fimbriae. The second most highly expressed gene of Aa encoded

leukotoxin, an important virulence factor. Additionally, Aa upregulated genes for anaerobic metabolism and

iron acquisition. The data show that Aa was highly virulent when grown in co-culture with Smu.

25



Non Conventional Removable Prosthodontic Devices

Mohamed Khaled Ahmed Mohamed Azzam

Ministry Of National Guard Hospital-Wr,Saudi Arabia

Prosthodontics is defined as “The branch of dentistry pertaining to the restorations and maintenance

of oral functions, comfort, appearance, and health of the patient by the restoration of natural teeth

and/ or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial

substitutes” .The traditional core of prosthetic dentistry consists of fixed and removable ( partial and complete)

prosthodontics.In few countries ,maxillofacial prosthodontic is still considered to be part of oral surgery.

Currently it is a major part of removable prosthetics modified by implants occasionally. Stomatognathic

physiology (occlusion) is actually one of the basic disciplines for prosthetic dentistry, just as it is the basis

for most clinical dental disciplines. Since the relationship between temporomandibular disorders (TMD)

and occlusion is not so close as previously presumed (De Boever & Carlsson),and as the current trend to

emphasize the pain aspect of the TMD more than its dysfunctional aspect hence Stomatognathic physiology

is placed as an independent position. Also many related disciplines are closely related to prosthetic dentistry

as Periodontology – Restorative dentistry – Implant logy – Gerodontology – Pediatrics – Orthodontics.

All these devices will be explained in a simplified way for all audience so that any general dentist and

specialized Prosthodontist can construct them in benefit for all our patients. So it is evident that Removable

Prosthodontics shows great variation and is in continuous phase of rapid development as in other areas of

clinical dentistry. Hence the need for conventional and non conventional removable prosthesis will continue

to be an essential part of everyday dentistry.

In conclusion to successfully treat patients a great deal of information is required to complete a proper

diagnosis, including patient mental attitude, past and present medical and dental conditions, and extra and

intra-oral examinations and in addition to the clinical experience and skill of the whole dental team.

Biography :Dr Mohamed Khaled Azzam is an Associate Professor and Consultant Removable Prosthodontist. He was former Assoc. Professor in Removable Prosthodontic Department in the Dental School –King Abdulaziz University (1992-2002). Currently is the Departmental Academic and Intern coordinator, member of the Dental Laboratory Quality Improvement Committee, Deputy of the Department Quality Control Champion and Clinical supervisor of Saudi board dental students and dental interns -- King Abdulaziz medical City, Ministry of National Guard, Jeddah, Saudi Arabia. He completed his Master’s and Doctorate degrees from Dental School- Cairo University, Egypt, and a Clinical Certificate in Prosthodontics from Tuft’s Dental School, Boston, USA in 1991. He has also published papers in reputed journals and presented many presentations locally in Saudi Arabia and many other internationally

26



Re-visiting the Decay, Missing, Filled Teeth (DMFT)

index with a Mathematical modeling concept

Amar Hassan Khamis

HBMCDM, United Arab Emirates

The well-established DMFT index has been used for over 75 years as a key for measuring dental caries in

dentistry. DMF is applied to permanent dentition and expressed as the total number of teeth decayed

(D), missing (M), or filled (F) in an individual. The current study will attempt, to create mathematical

model for the existing DMFT index as a fixed model; in which all individuals under screening will have the

same probability θ, 0 ≤ θ ≤1 of dental caries. In this fixed model the unit of the screening is the individual,

and will be evaluated for caries as a dichotomous variable. Mathematically, the model will highlight what the

value 1 will hide as information and hence explain why the average of DMFT is over estimated for any sample

studied. Alternatively, the new suggested model may be considered a random model, that suggests a mouth

of an individual as an environment and the tooth is a unit of research. In this random model, only the teeth

in one mouth have the same probability θi, 0 ≤ θ

i ≤1 where i = 1, 2, …, k; number of screening individuals.

This model will yield a cumulative weighed probability on the function of the number of teeth screened per

mouth θ, 0 ≤ θ ≤1, hence the average DMF index will be weighed against the number of teeth screened per all

subjects. This will yield an average and more realistic expected value for the population studied. Furthermore,

in such models, it is easy to estimate the variances and it is obvious that the random model yields the smallest

variance.

27



Intra-maxillary Drug delivery and Bio-sensing via Dental

Implant and its considerations

Li Yu-Jung

St. Mary’s Junior College of Medicine, Taiwan

Due to lack of the pulp structure and periodontal ligament (PDL) as the mainly pain origin among

the tooth structure, dental implant provide an opportunity for the painless drug delivery and bio-

sensing. This newly drug delivery and bio-sensing pathway presents in a long-term steady and

continuous properties, which may lead to various medical applications for patients with the demand of

frequently invasive procedures. For example, patients suffering from diabetes mellitus (DM) may need four

invasive blood sugar detection and subcutaneous injections of insulin to control blood sugar levels each day

in the later stage traditionally. With such device, they may avoid such frequently invasive procedures. The

device contains drug delivery and bio-sensing modules, which are replaceable and present in semi-implanted

property due to directly placed above the fixed implant fixture as the prosthetic abutment. The drug delivery

module contains a piezoelectric micro-pump, drug container, and power supply inside. While the bio-sensing

module is constructed by the integrated circuit (IC), Bluetooth and power supply for wireless control. In

vitro experiments, simulations and the preliminary canine study provide the positive results. However, such

device development is just beginning and further improvements along with the standard dental procedure

establishments are needed. Finally we will discuss about the challenges and the related dental considerations

about this intra-oral device including the maintenance of osseointegration and its infection control.

Biography :Yu-Jung, Li currently is a lecturer at St. Mary’s Medicine, Nursing and Management College, and responsible for pathology,

human anatomy lecture with experiment, experiment of physiology, clinical laboratory and diagnostic tests. He completed

his training program of Oral and Maxillofacial Surgery in Veterans General Hospital-Taipei, Taiwan during 2002-2006. He

entered the Ph.D. Course in 2010 and currently is a doctoral candidate, majored in mechanical and electrical engineering

from National Taipei University of Technology. Earlier he received MS degree of Clinical Dental Science from Institute

of Clinical Dentistry, National Yang-Ming University. He also received MS degrees of Chemistry and Biophysics from

Graduate Institute of Biophysics, National Central University, and Institute of Chemistry, Tamkang University during

2006-2010. He got bachelor degree of dentistry from Department of Dentistry, Chung Shan Medical University in 2002.

28



Study of effect of Polyvinylpyrrolidone-iodine (PVP-I)

2% as an anti-oedematous agent in third molar surgery

Kanwaldeep Singh Soodan

M M University, India

A single blind randomized control trial was carried out on 50 healthy outpatients who required surgical

removal of Mandibular third molars under local anesthesia were selected. The patients were divided

into 2 groups (n = 25), the treatment (PVP-I) and control group (normal saline). The treatment group

patients were irrigated using PVP-I 2% (w/v) (Betadine, Win- Medicare, India) during bone guttering and

tooth sectioning. The control group patients were irrigated with saline (sodium chloride 0.9%, w/v; Parentral

Drugs, India) only. Procedures that exceeded more than 1 hour were excluded from the study. Using Pederson

difficulty index, patients with moderately difficulty index were chosen. All parameters for swelling were

recorded preoperatively, on the first, second and seventh postoperative days for both procedures. The data

were statistically analyzed using SPSS (version 22.0) software. Independent t-test was applied for Operative

time in minutes and the two groups matched (p>0.05) for operative time. For change in swelling, T-tests

was applied and we found increase in swelling in saline group which was highly significant for change from

preoperative to day 2 (p=.005) and from preoperative to day 7 (p-value<.001). Mean for Pederson index

for Betadine and saline group was found out to be same (P=1). PVP-I 2% was found out to be significantly

reducing swelling as compared to saline suggesting that it acts as an anti-oedematous agent in mandibular

third molar surgery.

Biography :Dr. Kanwaldeep Singh Soodan is Associate Professor / Reader at M M College of Dental Sciences and Research, India.

He completed his B.D.S. from Magadh University (India) in 2003. He did his M.D.S. (Oral & Maxillofacial Surgery)

from Bharati Vidyapeeth University, Pune (India) in 2009. He has working experience in Cleft & Cranio-maxilofacial

Surgery Unit (Chennai, India) and Tata Memorial Cancer Hospital (Mumbai, India). He has published 7 international

and 12 national articles till date. He has 7 International book publications to his credit. During his post as Associate

professor / Reader, he has completed 2 Research works and in progress with 1 more. He has done international and

national presentations. He is Editorial board member to 4 international Journals, 4 national journals and Reviewer to

Pubmed indexed journal. He has acted as “Chairperson” during the scientific deliberations at State level and Annual

conference of AOMSI.

29



Isolation, Identification and Antibiotic Susceptibility

Profiles of Bacterial Strains Isolated from Supragingival

Plaque of Periodontal Patients in Addis Ababa, Ethiopia

Abera H. Bedane

Addis Ababa University, Ethiopia

Background: Periodontal disease is one of the most human being health problems worldwide. Poor oral

hygiene is the potential causes of biofilm formation over the surface of the tooth and it is constantly

forms supragingival plaque that cause periodontal disease. The aim of this study was to identify

bacterial and determine the antibiotic susceptibility profile of supragingival plaque from patients’ at dental

service and training center of Addis Ababa University.

Materials and Methods: A cross sectional study was conducted on 384 patients from April 2015 to June 2015. After

having a signed consent, data was collected using standardized questionnaire and samples were collected aseptically

with special care from supragingival plaque of periodontal patients using conventional sampling method and

transported to the lab using thioglycolate broth medium within two hours for microbiological analysis.

Result: From the total of 384 study participants 52.9% were males and the median age of the respondents was

35 years. Poor oral hygiene status was seen in 89.8% of the participants. Gingival recession and calculus was

very common. 40.1% of the study participants were severely affected by periodontal disease. Microbiological

investigation of samples led to the isolation 459 different types of bacterial strains with a variety of morphological

types. 31.8% (n=122/384) of subjects showed more than one type of bacterial growth. The most frequently

isolated species were Gram positive facultative anaerobes followed by anaerobic gram negative rods.

In Ethiopia clinicians mostly used Beta Lactams in combination with metrindazole or alone for the empirical

treatment of periodontal disease. In Our study we have seen a significant number of resistant bacteria for 3rd

generation Cephalosporins including Ceftraxone, Erytromycin and Clinadmycin. The antibiotic susceptibility

patterns of Gram-positive facultative anaerobes mainly streptococcus species show high resistance rates to

Ciprofloxacin 20.5% and Amoxacillin 20.3%. In our study, of the isolates resistant to Penicillin G 1 Unit, 84%

were also resistant to amoxicillin.

Conclusion: An increased periodontal diseases and multiple drug resistant periodontal pathogens were

isolated. So efforts should be made to reduce periodontal disease through health education and increase

dental microbiology isolation facilities. Continuous monitoring and reviewing of antimicrobial policy in

dental health is also needed.

Biography :Abera H. Bedane is Lecturer and external relation coordinator of Addis Ababa University, Dental School since January

2013 and Clinical Biochemistry lab head of the same University from 2006 to 2012. He obtained doctor of dental medicine

(DDM) from Atlas College of health Science in Aug. 2013 and BSc. in medical lab technology in 2006 from Addis Ababa

University. Currently active member of Ethiopian dental association

Kassu D. Tulu is Ass. Prof. of Microbiology in Addis Ababa University, he was a head department of Medical lab Technology

from 2007 to 2010

Session 1Dental Implants Advanced Education in General Dentistry

Title

Title

Title

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33



Immediate loading with a new concept of maxillary sinus

elevation: S-reamer osteotome technique

Richard Leesungbok

Kyung Hee University, South Korea

The malleting osteotome technique for maxillary sinus graft still comes with the magnitude of forces and

the amount of heat. Once in a while, this malleting osteotome technique arises several post-operative

complications such as discomfort and inner auditory organ damage. Also the possibility of damage

on the sinus membrane with excessive fracture of sinus floor still remains. This report introduced a new

maxillary sinus floor elevation technique in which only the inferior cortical wall underneath the sinus would

be perforated without tearing of maxillary sinus membrane by drilling instead of malleting using a rotary

instrument, called S-reamer® (Neobiotec Co., Korea).

Aim:The objective of this presentation is to show our scientific and clinical experience related to implant

supported fixed restorations for the partially and fully edentulous jaws including a situation after sinus graft

with S-reamer osteotome technique, and to assess the survival outcome of immediate loading protocols

according to their treatment sequence and selected prosthodontic design.

Methods:S-reamer used in this report was designed to remove the bone beneath maxillary sinus floor without

tearing any maxillary sinus membrane. 104 implants for 32 patients were placed with help of S-reamer in

order to increase vertical bone dimension on the posterior maxillae, and had immediate restorations after

implant surgery with this sinus elevation procedure at Kyung Hee University East-West Neo Medical Dental

Hospital (Seoul, Korea) since 2006. The bone chip is collected in the head of the reamer that has the letter ‘S’

shape, making the head surface smooth to prevent the tearing of the membrane. The image of S-reamer was

captured from the recorded video clip when it was drilling on the sinus wall of a pig in a simulation test. It

revealed that moving drill did not tear the sinus membrane even though it was pushing over the border of

inner sinus wall.

Results:The initial remained bone thickness between sinus floor and alveolar crest were various from 5 to

10mm. As a result, 8mm to 10mm length of implants were installed according to site preparation including

internal sinus augmentation. The post-operative CT image demonstrated that about 2-3.5 mm grafted material

was detected on the apex of implant fixture. There were no perforation of membrane or no post operative

complications reported.

Conclusions and clinical implications:The newly designed “S-reamer osteotome technique” can be used

as a predictable alternative treatment modality as compared with malleting osteotome technique as well as

external lateral window approach. This technique would be a minimal invasive sinus floor elevation procedure

and an effective way to achieve immediate loading due to the sinus inferior cortical fixation on the posterior

maxilla.

Biography :Dr. Leesungbok is the full professor and Chair at the Department of Biomaterials and Prosthodontics. He is also the head

at the Center of Esthetic Dentistry, Vice-president at the East-West Neo Medical Center Dental Hospital, Kyung Hee

University Dental School, Seoul, Korea. His specialties are in the areas of Implant Dentistry, Maxillofacial Prosthodontics,

34



and Human Jaw Function and Occlusion. His special interests include Esthetic Dentistry, Magnetic Dentistry, and Sports

Dentistry. He is an active member of the IRPMD(international research project for magnetic dentistry), and a fellow and

education delegate of ITI(international team for implantology). He studied in Ohu university(1991-1992) at Koriyama in

Japan as an invited scholarship researcher, and Nippon Dental University at Niigata(1994) in Japan as a visiting associate

professor, and worked for Harvard University School of Dental Medicine(1997-1999) in the USA as a visiting associate

professor(Head; Prof. Dr. Hans Peter Weber). Dr. Leesungbok’s research focuses on the utilization of magnets in clinical

dentistry and on study of magnetic effect to bone formation around dental implants. He is also doing many researches

in attempts to find out the relationship between human occlusion and cerebral/neuromuscular system. Over the past 17

years, he has given more than 200 lectures at different professional and scientific meetings/courses and universities both in

Korea and throughout the world including ITI World Symposium in Sandiego(2003) USA and Munich(2005) Germany.

He awarded the Best Academic Thesis Award at Annual Scientific Meeting on The Korean Academy of Prosthodontics

1992, The 12th Ko-Hwang Medical Silver Award (Thesis: A study on the normal and abnormal occlusal patterns in adults

using the superimposed rubber pattern method) in 1996, and The 15th Ko-Hwang Medical Silver Award(Thesis: A

finite element stress analysis during experimental loading on the implant-supported prostheses; a scientific designing of

KH98 standard mandible for finite element method) in 1999. He also awarded the Best Education Director on Magnetic

Dentistry, and Silver Award of The Excellent Thesis on Magnetic Dentistry International Symposium of IRPMD, Shanghai,

China in 2002

35



Effects of orthodontic materials on accuracy of cone

beam computed tomography–based caries detection

Ozlem Isman

Gaziantep University, Turkey

The aim of this study was to investigate the influence of orthodontic materials on assessment of

approximal caries by cone beam computed tomography. Non cavitated and restoration free 40

premolar and molar human teeth were located with approximal contacs into silicon blocks. CBCT

images were recorded with three orthodontic bracket materials and two diffrerent orthodontic arcwire and

without any materials. Planmeca, Promax, Finland was used with small field of view (FOV). Stainless steel,

plastic, porcelain brackets and stainless steel, nickel titanium (NiTi) arch-wire were included. Two observers

assessed the images by using five point scale. Intra and inter observer agreement was computed by using

Intra class correlation coefficient. Receiver operating characteristic (ROC) analysis was used to calculate the

true positive value (TPV), true negative value (TNV), and area under the ROC curve (AUC). Az values were

compared by using MedCalc comparison of area under roc curve. Inter observer agreement ranged between 0,

59 and 1, 00. Intra observer agreement ranged from 0,44 to 0,92. Teeth without orthodontic materials showed

highest Az values with 0,84. Most successful group was the group without bracket and arch-wire. Az values

of groups were determined between 0,51 and 0,84. Given the limitations of this study, adjunct orthodontic

materials effects the success of approximal caries detection on CBCT.

Biography :Özlem İşman was born in 1983 in Turkey. She graduated from University Of Ankara Faculty Of Dentistry on 2005. She

ran her own clinic between 2006 and 2011. She started her PhD education in Gaziantep University Faculty of Dentistry

Dentomaxillofacial Radiology department on February 2012 and graduated on December 2015. She is currently working

in same faculty as a prelector. She has many scientific papers in international scientific journals.

36



Do we really need to use metal primers in every amalgam

restorated teeth?

Eren Isman

Gaziantep University, Turkey

Many clinicians encounter problems of bracket lose during orthodontic treatment. A huge number of

these losts are originated from poor attachments. Buccal amalgam restorations remain unwanted

causes of bracket and orthodontic tube losts. To get rid of this matter, scientists have developed

specific primers for amalgam restorations. However, the restoration dimensions may vary from a very tiny

spot to a large area coving all the buccal side of the teeth. In which size of restorations do we really need to

use metal primers?

The aim of this study was to evaluate the shear bond strength (SBS) of orthodontic molar tubes bonded to

amalgam restorations and enamel with four different area ratios, with and without the use of various metal

primers. One hundred and fifty-six sound lower first molars were divided into five groups; control group

(CG;n = 12) then divided into three subgroups: A, B, and C. Class V buccal amalgam restorations consisting

of 25%(G1), 50%(G2), 75%(G3), and 100%(G4) of the basal areas of the molar tubes. Transbond XT Primer

(TXTP;subgroup A), Alloy Primer (AP;subgroup B) and Reliance Metal Primer (RMP;subgroup C) (n =

12). Transbond XT was used as an adhesive material in all groups. Thermocycling was as 5 –55 °C, 1000

cycles. Data were analysed by one-way ANOVA and post hoc least significant difference tests (p < 0.05).

Bond failure sites were classified using a modified Adhesive Remnant Index (ARI) system. SBS did not differ

significantly among the three intermediate adhesives in subgroups of groups 1, 2, or 3 (p > 0.05); however, SBS

was significantly higher in groups 4B and 4C than in group 4A (p < 0.05). Mean SBSs of groups 1 and 2 were

significantly higher than others (p < 0.05). Mean SBS of group 3 was higher than that of group 4, but lower

than that of the other groups. For ARI, significant relationships between CG and the intermediate adhesive

groups were found (p < 0.05). Application of metal primers, such as AP or RMP, to sandblasted amalgam

adjacent to etched enamel (25, 50, and 75%) did not improve bond strength significantly compared with the

application of TXTP to amalgam and enamel.

Biography :Dr. Eren ISMAN, Assoc. Prof., DDS, Ms, PhD; born in Antalya/TURKEY in 1980; is the chair of Orthodontic Department

at Gaziantep University, Faculty of Dentistry since 2012. He also is a member of the board of directors of the same faculty.

He received his DDS degree in 2004 from Ataturk University, Faculty of Dentistry. He then enrolled in Ms and PhD

Degrees in Selcuk University, Faculty of Dentistry, Department of Orthodontics. He has succeeded having his PhD degree

with his thesis about the genetics of tooth development malfunctions. He has many scientific papers about dental material

studies, dental genetics and biomechanics. He continued his academic life in Gaziantep University, Faculty of Dentistry,

Department of Orthodontics since 2009. He has achieved many scientific project grands from National Scientific Project

Agents.

37



Evolution In Non-Surgical Periodontology

Archita Vaishnav

Hemchandracharya North Gujarat University, INDIA

A person’s total health is indeed related to their oral health. Periodontal diseases are bacterial disease

non-surgical therapy removes plaque and calculi by controlling the growth of harmful bacteria .These

diseases are often familiar, suggesting a genetic predisposition for aggressive disease. Elimination of

all oral infections, including gingivitis and periodontitis, is important to overall health. Periodontal disease

must be viewed from a whole new perspective, particularly since some form of periodontal diseases are

present in large percentage of population. In patients with few or no risk factors, periodontal disease can be

reversed with early non-surgical intervention. With knowledge, a patient will be much more likely to say YES

to non-surgical treatment plan. In past there were not much treatment options for non-surgical therapy but

nowadays there are so many treatment options available. So we can say that there is an evolution or changes

in treatment patterns. This paper shows various new trends in non surgical and therapy that will successfully

arrest periodontal infections.

Biography :Dr. Archita Vaishnav has completed her BDS at the age of 24 years from Rajasthan University and she is doing her post

graduation in Periodontology form Narsinhbhai Dental College. She attended 40th ISP NATIONAL CONFERENCE and

presented a poster on ‘Nanotechnology In Local Drug Delivery’. She also attended two CDE Lecture in 2013 ‘MTA &

Regenerative Endodontics’ and in 2015 ‘Retreatodontics & Rotary Endodontics’. She also attended ‘Rajasthan State Dental

Conference 2012 (IDA)’.

38



Assessment of implant stability of two-piece zirconium

dioxide implants

Mustafa Tattan

RAK College of Dental Science, United Arab Emirates

Objective: The aim of this pilot study is to evaluate to value of primary implant stability for two-piece

zirconia implants and longitudinally stability changes of implants during the healing period of 16

weeks.

Material and methods: Ten patients treated with twelve two-piece non-metallic zirconia dioxide root shape

implant ( 4/10mm, Axis Biodental, Les Bios, Switzerland) for single tooth replacement in the upper premolar

area. Resonance frequency analysis (RFA) were used for assessment of longitudinally changes of implant

stability during 16-weeks observing period. All patients have been re-evaluated 1 year after loading.

Results: Mean ISQ value of initial implant stability for 12 implants was 60.25 (3.72). Statistically significant

decrease was noted in the first three weeks after insertion (p=0.000). Also statistically significant increasing of

implant stability was recorded for observing period for 6th to 16th week.

Conclusion: Increasing of ISQ value during observing period suggests loading of two-piece zirconia dioxide

root shape implant for single tooth replacement in the upper premolar area, after healing period of 4 months.

Title:

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41



The assessment and treatment of dental fear and anxiety:

A clinically proven public health approach

Lynn M. Tepper

Columbia University, New York, NY USA

Somewhere between 20-40 million Americans (10%) avoid the dentist due to fear/anxiety, and 3-5% are

clinically phobic, avoiding dental treatment entirely. Global data of industrialized nations supports these

numbers, with remarkably increased rates reported among third world countries. Phobic patients have

on average four times as many missing teeth and peri-radicular lesions. Phobic patients have significantly

greater periodontal bone loss, and increased dentally-related systemic illness then the non-phobic population.

Recent research indicated that 57% of dentists consider difficult/fearful patients as the single most stressful

factor in their practice. Fearful patients are prone to canceling or skipping appointments which can be a

major scheduling challenge and practice inconvenience.

Avoidance due to fear/anxiety detrimentally affects a patient’s oral health and thus also detrimentally affects

his or her systemic health. Though these patients can be a challenge, it is our duty as health care providers to

serve the needs of this section of the population just like any other.

This presentation will describe the epidemiology, etiology, and treatment of dental fear and anxiety, as well

as its emotional, physiological, and behavioral components, which reflects our research over the past three

years. Various assessment approaches used to measure fear and anxiety will be described and evaluated.

It will present the most recent research regarding various treatment methodologies, including cognitive

restructuring, relaxation, systemic desensitization, and stress-reduction communication approaches which

have been proven to be effective. Our most recent research findings regarding the impact of dental phobia

on quality of life will be emphasized throughout.

Biography :Lynn M. Tepper is Clinical Professor and Chair of the Behavioral Science Department at Columbia University College of

Dental Medicine, and the Mailman School of Public Health at Columbia, where she has been since 1983. She also heads

up the Dental Fear and Anxiety Program which supports a translational research program since 2009. She received her

BS degree from SUNY Buffalo, her MS degree from Wayne State University, and her MA, EdD, and PhD degrees from

Columbia University where she was the Heft Scholar in residence. She was the Post Doctoral Fellow in Gerontology at the

Gerontological Society of America, and has dedicated her career to teaching, research, and clinical practice in behavioral

medicine.

42



A case of undiagnosed Harlequin Syndrome presenting

in general dental practice

Kathryn Edwards

Community Dental Officer Northumbria Healthcare, United Kingdom

Harlequin syndrome is a rare, clinically striking syndrome characterized by distinctly demarcated

asymmetric facial flushing and sweating. It may be of idiopathic aetiology or caused by demonstrable

ipsilateral damage to the sympathetic nervous system. We describe a case where a patient who

presented to her general dental practitioner (GDP) complaining of distinctly demarcated unilateral facial

flushing and sweating. Onward referral resulted in a diagnosis of Harlequin syndrome. Although Harlequin

syndrome is usually of benign nature and does not require treatment, the signs and symptoms should be

fully investigated and evaluated to exclude a serious underlying cause. Neurological disorders may present in

various ways including unilateral facial flushing and sweating. This case report highlights the role of the GDP

in recognising signs and symptoms within the head and neck that may warrant appropriate medical attention.

Biography :Kathryn Edwards graduated from Newcastle University in 2009 achieving her BDS with Honours. She later completed

her MFDS exams with the Royal College of Surgeons Edinburgh in 2011. She has worked in both primary and secondary

care as a General Professional Trainee, Dental Core Trainee in Maxillofacial Surgery and Orthodontics, and as a General

Dental Practitioner. She particularly enjoys teaching and has supervised undergraduate dental students both in the UK

(Newcastle University) and Australia (University of Queensland). Kathryn is now working in the Community Dental

Service providing treatment to anxious children and special needs patients.

43



Effect of stress on periodontal diseases.

Archita Vaishnav

Narsinhbhai Patel Dental College, India.

Psychological factors may increase the risk for periodontal diseases. Contemporary conceptualization

of the stress process supports the evaluation of stress at three levels: stressors, moderating and

mediating factors, and stress reactions.Several studies in various populations have confirmed an

association between negative life events, the level of depression and anxiety, as well as personalitytraits and

periodontitis. This study was under taken to investigate the relationship of periodontal disease in terms of

clinical attachment level (CAL) to psychosocial stress.A cross-sectional study of 500 subjectsaged 15–64 years

in India was conducted. Subjects were asked to complete a set of questionnaires measuring stressors including

changes,significant life event and daily strains, stress reactions including physiological and affective responses.

CAL was assessed. Individuals with high mean CAL values had higher scoreson the job and financial strain

scales than periodontally healthy individuals(P < 0.05).Gingivitis and periodontitis are thought to result from

an imbalance between those oral microorganisms which normally colonize tooth surfaces in close contact with

the gingival margin, and the nature and efficiency of the host response. The bacteria are the triggering agents,

but host defence mechanisms within the gingival/periodontal tissues seem to be responsible for most of the

tissue damage and for the outcome and progression of the diseases. It has recently been shown that emotional

or psychological load(stress) may influence immune activities directly via nerve messenger substances

(neurotransmittersand neuropeptides) and/or indirectly via neuroendocrine (hotmone) substances.

Biography :She is doing her post graduation in Periodontology form Narsinhbhai Dental College. She attended 40th ISP NATIONAL

CONFERENCE and present a poster on ‘Nenotechnology In Local Drug Delivery’. She also attended two CDE Lecture

in 2013 ‘MTA & Regenerative Endodontics’ and in 2015 ‘ Retreatodontics & Rotary Endodontics’. She also attended

‘Rajasthan State Dental Conference 2012 (IDA)’.

44



Methotrexate Pharmacotherapy for Implant-related

Temporomandibular Joint Pain: A case report

J Paul Edwards

MyDentist, , United Kingdom

This case report presents a patient experiencing several years of pain associated with bilateral failed

temporomandibular joint (TMJ) Proplast/Teflon fossa prostheses. Despite surgical removal of the

prostheses and comprehensive conservative management, including typical pharmacotherapy

approaches for chronic pain, pain was still not relieved and management was revised to target a putative

chronic inflammatory disorder at the TMJs. Methotrexate was prescribed due to its known efficacy for

inflammation and pain reduction in Rheumatoid Arthritis. Titration of Methotrexate dosage over 5 months

to a weekly dose of 20mg resulted in reduced pain intensity at rest, increased pain-free maximal jaw opening,

and a reduction in the sensory component of the McGill Pain Questionnaire. Maximum assisted jaw opening

remained the same, as did palpation tenderness of both TMJs, masseter muscles and temporalis muscles.

Methotrexate pharmacotherapy may represent a viable option when conservative treatments have failed to

provide significant pain relief post Proplast/Teflon TMJ implants.

Biography :Paul Edwards graduated from Newcastle in 2010 in Dentistry and later became a member of the Glasgow Royal College.

He has worked in primary and secondary care. His initial post as a General Professional Trainee exposed him to multiple

dental specialties, allowing him to acquire a broad knowledge base and skillset. He then pursued his specialist interest in

Oral Surgery, holding Senior House Officer and Specialty Doctor posts at Newcastle and Ormskirk Hospitals respectively,

developing surgical skills and performing more advanced techniques. Since graduating Paul has published several research

papers in international journals. He is currently training in dental implants.

45



Knowledge, Attitude And Practice Of Patient Attending

Outpatient Dental Clinics About Infections Can Be

Transmitted Through Dental Treatment

Asraa khairallah turkistani and Samaa Sangoof

King abdulaziz university University, jeddah, Saudi Arabia

Background: Patient safety is a relatively recent science aimed at improving patients’ care, minimizing

treatment risks and mistakes. Many cross-infection can be transmitted through dental clinics.

However, limited number of studies was conducted in this important area. Objectives: To determine

knowledge, attitude and practice of patients attending dental clinics in King Abdulaziz University Hospital

(KAUH) about cross- infections and infection control measures should be taken during dental treatment.

Methods: A cross-sectional study was conducted among 225 patients attending dental clinics in KAUH in

Jeddah during 2014. Patients were interviewed using a confidential, anonymous interviewing questionnaire

to collect personal, socio-demographic data, knowledge, attitude and practice regarding dental infections

and infection control. Both descriptive and analytic statistics were done and knowledge score was calculated.

Results: It was found that 39.6 %, 38.7 % and 21.8% of the participants had poor, fair and satisfactory

knowledge scores, respectively. Participants’ education affects their level of knowledge, with highly statistical

significant difference (X2= 15.428, p < 0.001). Almost 99% of participants agreed that dentists should always

wear gloves. While 80% of them agreed that replacing gloves after receiving phone call is essential. Among

44.9% participants who had been treated by a dentist who wasn’t wearing facemask, 13.3% asked their dentist

to wear it, whereas others didn’t ask because they don’t mind, were afraid or shy 11.1%, 1.8% and 18.7%,

respectively.Conclusion: Patients attending dental clinics of KAUH demonstrated non-adequate knowledge

concerning dental infection. However they had better attitude toward most of infectious control measures.

46



Comparative evaluation of cytotoxicity for two types of

endodontic sealers

Shima Sadat Miri

Kermanshah University of Medical Sciences, Iran

The objective of this study was to evaluate the cytotoxicity of MTA Fillapex and AH26.after preparing

the 24- and 72-hour sealer extracts,their cytotoxicity potential on the Saos-2 and MG-63 cell types

was evaluated by MTT assay and Trypan Blue exclusion technique. the cytotoxicity potential of 24

–h extract of MTA Fillapex in dilution of 1:4 and 1:4,1:8 on the Saos-2 and MG63 respectively was higher

than that of control. this finding was observed for the 72-h extract in dilution of 1:4,1:8 and 1:16 on the two

cell types. for 24-h extract of AH26, a higher cytotoxicity on the two cell types was shown in dilution of

1:4 ,1:8,1:16 and for the 72-h extract in all dilutions.no significant difference was found between the sealer

extracts(p>0.05).in conclusion ,MTA Fillapex and AH26 were equally toxic on the two cell types.

Biography :Dr Shima sadat Miri has graduated from Islamic Azad university of medical sciences in general dentistry, Tehran, Iran. She has graduated from Babol university of medical sciences in endodontics specialty and has started to work in the endodontics Department of Kermanshah university of medical sciences as the assisstant professor. She has published more than 7 papers in reputed journals . Now She is the Head of student Research Committee in Kermanshah university. She won the top researcher place of the 2016 in Kermanshah city.

47



Management of Moderate Tetracycline Stains and Fluorosis

using Porcelain Veneers: Presentation of Two Cases

Adil Shahnawaz

Islamabad Medical & Dental College, Pakistan

This presentation will emphasize the importance of different esthetic procedures including porcelain

veneers, bleaching and micro-abrasion in management of moderate tetracycline stains and fluorosis

respectively.

Case No 1: 35 years old female patient reported with moderate generalized tetracycline stains and slight

spacing in the lower anterior teeth. The entire case was managed using porcelain veneers. Case No 2:28 years

old female patient reported with fluorosis which was managed by combination of micro-abrasion, in-office

vital tooth bleaching and porcelain veneers. Porcelain veneers have proved their role in masking different

types of tooth discoloration with minimum loss of tooth structure. The presentation will encompass different

steps involved in tooth preparation along with the armamentarium involved.

48



First Permanent Molars With Poor Long-Term Prognosis

In Children; Review of Treatment Plans

Matin Abed Haghighi

Shiraz University of Medical Sciences, Iran

During the mixed-dentition stage of dental development, dentists may encounter patients with first

permanent molars considered to have a poor long-term prognosis. In this situation, extraction of the

tooth should be considered. The aim of this article is to discuss about treatment planning for patients

who have first molars with a poor prognosis during the mixed-dentition stage.



Pathology of salivary gland neoplasia: An update

focusing on new entities and novel diagnostic and

prognostic markers

Abbas Agaimy

University Hospital Erlangen, Germany

Pathology of salivary gland neoplasms has been undergoing study evolution during the last decade.

This was mainly a consequence of introducing several innovative adjunct tools in the classification

of neoplastic diseases, in particular the introduction of new molecular technologies including next

generation sequencing but also the effect of seminal simple morphological observations. As a result, several

new entities have been recognized and some old entities defined as novel neoplasms. This objective of this

overview lecture is to summarize the new developments in the pathology of salivary gland neoplasms with

emphasis on new entities and new molecular markers.

49

50



An In Vitro Determination of Root Canal Length and

Auto Apical Reverse Motion Using Dentaport Root Zx

and Tri Auto Zx Respectively at Correct Working Length

Adil Shahnawaz

Islamabad Medical & College, Pakistan

The development of electronic apex locators (EALs) has helped in making the assessment of working

length more accurate and predictable. Now a days EALs are used in combination with electronic apex

locator (EAL) controlled handpieces which help in canal preparation at the correct working length.

This study was conducted on a third generation EAL i.e. Dentaport Root ZX and Tri Auto ZX which is EAL

controlled handpiece. The objective of this in vitro study was to determine root canal length with Dentaport

Root ZX and to compare it with correct working length measured through direct method and the ability of

Dentaport Tri Auto ZX to start its auto apical reverse motion at the working length obtained by Dentaport

Root ZX.

Method: 72 extracted anterior teeth were obtained. Their incisal surfaces were ground so that each tooth

should measure between 13mm and 18mm. Their correct working length were taken by direct method (DL)

and with the help of EAL i.e. EL. Then the AAR motion of Tri Auto ZX was tested at EL.

Results:The difference between the correct working length obtained by direct method DL and electronic apex

locator i.e. EL is statistically not significant (P> 0.05). Tri Auto ZX was able to start its AAR motion at EL IN

84.72% cases.

Conclusion: It was concluded that Dentaport Root ZX is reliable to determine the correct working length

when compared with the direct method. However the ability of Dentaport Tri Auto ZX to start its AAR

motion at the root canal length determined by EAL requires close monitoring.

51



Three-dimensional evaluation of airway and sleep apnea

Ahmed Ghoneima

Indiana University Purdue University, United States

Airway volume and respiratory function are highly relevant to the dental and orthodontic specialty.

Studies have confirmed that airway problems are significantly related to different types of malocclusion

and that nasal obstruction is a major etiological factor for dentofacial anomalies. In growing

patients with skeletal discrepancies and signs of adenoid facies, early diagnosis, prediction, and assessment

of the functional aetiological factors are critical for the restoration of normal craniofacial growth and the

stability of the treatment outcome. Evaluation of the airway is an essential diagnostic step for patients with

breathing disorders such as obstructive sleep apnea (OSA). In these patients, airway assessment has been

mostly performed on two-dimensional lateral cephalograms by identifying special landmarks and measuring

various lengths and areas in the airway region. This method of assessment is doubtful since using the two-

dimensional lateral or frontal cephalograms does not allow identification of the soft tissue contour in the third

dimension thus limiting evaluation of areas and volumes. Currently, the advances in computed tomography

(CT) imaging and the three-dimensional technology allow better visualization of the airway and volumetric

analysis. Clinicians can more easily perform the volumetric measurements and also calculate the cross-

sectional areas of the airway in three planes of space: coronal, sagittal, and axial. The axial plane, which is not

visualized on a lateral cephalogram, is the most physiologically relevant plane because it is perpendicular to

the airflow. Cone-beam CT (CBCT) systems have been developed specifically for the maxillofacial region with

the advantage of the reduced radiation doses compared with conventional CT. Accurate and easy evaluation of

the airway anatomy has been possible using those CBCT systems. The current lecture will focus on methods

and accuracy of 3D airway evaluation as well as the key diagnostic tips for OSA patients.

Biography :Ahmed Ghoneima, Assistant Professor and the Director of the 3D Orthodontic Imaging Laboratory at the Department

of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry (IUSD). He also currently serves as the

Director of the Orthodontic Fellowship Program at IUSD. He received his Dental Degree and Master of Science from Al-

Azhar University in Egypt and joined the Department of Orthodontics and Oral Facial Genetics at IUSD in 2008 where

he earned his Ph.D. degree and became a full time faculty. His research program focuses on the fields of airways analysis,

applications of 3D imaging in orthodontics, haptic technology and the use of the virtual reality in dental education. He

received multiple prestigious awards including the Michael Matlof Memorial and the Orhan C. Tuncay Awards from the

AAOF in 2013 and 2014 as well as the Academy for Academic Leadership Award in 2015. Dr. Ghoneima is chairing the

Indiana Section of American Association for Dental Research (IN-AADR) and he also serves as a reviewer for several

peer-reviewed orthodontic journals.

52



The impact of CPD hands-on courses on practitioners’ skills, Cavity preparation

Ali Nankali

Barts and The London School of Medicine and Dentistry, United Kinbgdom

Cavity preparation is one of a daily dental practitioner’ involvements, hence clinicians should be

confident for their preparations and achieve an appropriate designed cavity for planed restorations.

Inappropriate cavities may cause iatrogenic damages, recurrent lesions and impact on the oral health

care. This study demonstrated the impact of the lectures – Hands - On Continuing Professional Development

courses on outcomes and helped practitioners to recognise their weaknesses. Participants were divided in

three groups: 1- those who were not aware about their weaknesses, 2- those know about their issues yet don’t

know reasons, and 3- those wanted to improved their clinical skills and practice under supervision. It was

experimented that after finding the causes why they make these mistakes, most of practitioners adjusted their

work dramatically in a day time which demonstrated and approved the impact of dental laboratories courses

on improving patients’ cares followed by improving Oral Health Care.

Biography :Dr Ali Nankali is a clinical Lecturer in Oral Adult Health in the Barts and the London Medical and Dental School. In 1998, he took a keen interest in restorative dentistry which led him to commence his extensive research on application of post and cores. Following his research, he proposed to the scientific board of the Orthopaedic and Implant department of the NMU a number of novel inventions including Nankali Post System, Nankali bur as well as new classifications for Post/Core and Masticatory force. Dr Nankali was awarded his PhD in 2004 by National Medical University (NMU) in Kiev, Ukraine where he registered as a specialist in Prosthodontics. Furthermore, his engineering background in addition to his prosthetics and Maxillofacial clinical experiences helped him in achieving ground-breaking outcomes on his researches related to distribution of masticators force and mechanical strength of teeth’s hard tissues that brought him to the attention of the scientific community. At his current position, Dr Nankali is involved with undergraduate, postgraduate students as well as regularly running CPD and other courses.

53



Flapless dental implant surgery for patients on oral

anticoagulants: A novel bridging paradigm between

clinical technique and therapeutic guidelines (Warless

Procedure)

Sultan A Al-Mubarak

King Faisal Specialist Hospital and Research Center, , Saudi Arabia

It is well demonstrated that patients with prosthetic heart valves require lifelong follow up and anticoagulant

therapy. The optimal anticoagulant management of such patients during surgical dental treatment

has been contested for a long time. A minimally invasive flapless approach has the potential to reduce

bleeding and minimize surgical time, postoperative pain, soft tissue inflammation, and crestal bone when

compared with conventional dental implant placement. The aim of the two case reports is to show the clinical

predictability of dental implant placement using a minimally invasive flapless approach without reducing the

dosage of anticoagulants for patients on lifelong anticoagulant therapy. In this study, a 45-year-old woman

and a 58-year-old man who had undergone cardiac surgery and were currently under a full therapeutic level

of anticoagulation therapy (warfarin) were treated with flapless dental implant surgery without reducing their

anticoagulant dosage. Postoperative clinical and radiographic assessment showed no abnormality, minimal

signs of inflammation, and excellent healing. The combination of minimally invasive flapless dental implant

surgery with no interruption in the normal dose of the anticoagulant medications could be an improved

method for placing dental implants in patients on long-term anticoagulant therapy.

Biography :Prof. Sultan A Al-Mubarak obtained Post-Doctoral Fellowship in Clinical Periodontal Regenerative Therapy & Periodontal

Medicine, and Clinical and Research Fellowship in Periodontal Management of Medically Compromised Patients with

Emphasis on Diabetics from School of Dental Medicine and the Division of Endocrinology, Diabetes and Metabolism,

State University of NewYork at Buffalo and Kaleida Health, Buffalo, NY, USA. Dr. Al-Mubarak is an Editorial Advisory

Board member and Editorial Board Member of some of the international scientific recognized journals: Biological

Therapies in Dentistry, Bimonthly (USA), Journal of International Academy of Periodontology (UK), Clinical Implant

Dentistry and Related Research, USA.

54



Scaling and root planing combined with adjunctive

chemotherapy may improve glycated hemoglobin in

diabetics

Sultan A Al-Mubarak

King Faisal Specialist Hospital and Research Center, Saudi Arabia

Patients with diabetes who have periodontal disease have two chronic conditions, each of which may affect

the other, and both of which require frequent professional evaluations. The objective of this study was

to evaluate the effectiveness of scaling and root planing (SRP) and adjunctive chemotherapy on gingival

health and glycemic control in diabetics. A total of 346 type 1 and 2 diabetic subjects were randomized into

four test groups: (1) SRP at baseline + placebo tablets (twice/day for 3 months), (2) SRP at baseline + 20mg

doxycycline hyclate (twice/day for 3 months), (3) SRP at baseline and 6 months + placebo tablets at baseline

and 6 months for 3 months and (4) received SRP at baseline and 6 months + doxycycline hyclate 20mg at

baseline and 6-month for 3 months. TNF-a, IL-1a, glycated hemoglobin (HbA1c), dental measurements

were collected. Results showed that all groups achieved statistically significant improvements for most of

the dental parameters at follow-up visits compared to baseline. A scaled-down statistical analysis of HbA1c

for those subjects with baseline readings ≤ 8.8% within each individual treatment group showed a steady

but continuous (and significant) numeric reduction associated with an improvement in periodontal health.

Interestingly, this significant reduction was observed when those subjects with HbA1c ≤ 8.8% (n = 132)

within the four groups combined together. In conclusion, SRP and adjunctive therapy improved periodontal

inflammation in diabetics; furthermore, the study reported that eliminating periodontal inflammation may

significantly reduce glycated hemoglobin levels for subjects with HbA1c ≤ 8.8%.

Biography :Prof. Al-Mubarak obtained Post-Doctoral Fellowship in Clinical Periodontal Regenerative Therapy & Periodontal

Medicine, and Clinical and Research Fellowship in Periodontal Management of Medically Compromised Patients from

School of Dental Medicine, State University of New York at Buffalo and Kaleida Health, USA. Prof. Al-Mubarak has

many publications at high impact journals, serves as an Editorial Advisory Board member and Editorial Board Member

of several international journals, work as an active member of research & ethics, innovation and incubation committees.

He is currently active as an Adjunct Professor at SUNY at Buffalo, USA and as Consultant Periodontist at KFSH&RC in

Riyadh, KSA.

55



Preparation and Evaluation of a New Calcium Based

Cement

Amer A. Taqa

Mosul University, Iraq

The aim of this research was the preparation of new calcium based cement, followed by evaluation of its

physical, mechanical, biological and antimicrobial properties, comparing the results with other base

restorative material (polycarboxylate cement and biodentine) under the American national standard

institute specification number 96 for water based cement. The powder of the new cement was prepared from

chicken egg shell while the liquid was polyacrylic acid, more than three thousands four handared formulas

were trialed until we reach the appropriate one. The reaction of cement was confirmed by Fourier transform

infra-red spectroscopy and Differential Scanning Calorimetry. The new cement was checked for setting time,

compressive strength, microhardness, film thickness, solubility, arsenic contents, pH analysis, antibacterial

properties and biocompatibility. Polycarboxylate cement and biodentine were used as a control material also

the results of the tested material were compared with the American national standard institute specification

number 96 for water based cement. The results showed that the setting time of the new cement was accepted

with ANSI/ADA Specification No. 96 for dental water-based cements. Specification, the new cement showed

compressive strength and microhardness higher than polycarboxylate cement and accepted with ANSI/ADA

Specification No. 96 for dental water-based cements. The new cement also showed a lower solubility than

polycarboxylate cement and accepted with ANSI/ADA Specification No. 96 for dental water-based cements.

The new cement was free from arsenic, the material show film thickness higher than ANSI/ADA Specification

No. 96 for dental water-based cements so that this cement can be used as a base material, pH of it comparable

with the pH of biodentine, the new cement showed better antimicrobial properties against (streptococcus mutans, Oral lactobacilli, Enterococcus faecalis) bacteria compared with biodentine and poly carboxylate

cement. The results of biocompatibility test showed that the new cement and biodentine were biocompatible

materials and better than polycarboxylate cement. In conclusion the prepared cement exhibits better physical

and mechanical properties than polycarboxylate cement and accepted with american national standared

institute specification number 96 for water based cement. The cement exhibited antimicrobial properties

better than polycarboxylate cement and biodentine material, the cement shows biocompatibility comparable

to biodentine material and better than polycarboxylate cement.

56



Teledentistry and oral health: a perfect match?

Amir Chater

UASBD, Tunisia

Objectives: Defining the origins, applications and the benefits of teledentistry in oral health

Methods: litterature review of evidence based applications and studies reports. Results: Teledentistry

has the potential to be a highly effective mechanism for enhancing early diagnosis and to be used in

dental education. Teledentistry has the potential to meet these needs by just logging into the side on interest

and getting relief immediately and thus has the ability to improve access to oral healthcare, improve the

delivery of oral healthcare, and lower its costs. It also has the potential to eliminate the disparities in oral

health care between rural and urban communities.

57



Utility of Digital Volume Tomography

In Maxillofacial Trauma

Anuraag B Choudhary, VSPM Dental College & Research Centre, India

To assess the diagnostic quality of images generated using the newly developed digital volume

tomography (DVT) system and comparing them with conventional images from patients with

maxillofacial Trauma.

Materials and Methods: The study population included 22 male patients aged 18 to 60 years with a History

of maxillofacial trauma. Each patient had undergone conventional radiographic and DVT examinations to

analyze the number of fracture lines in the jaws and to compare the images for their diagnostic quality by an

oral radiologist and a general radiologist using the _2 test.

Results: A statistically significant difference was found between the number of fracture lines evaluated on

the conventional radiographs and on DVT, especially for condylar head (7) and the midface (4.41 to 4.57),

zygomaticomaxillary complex and Le Fort fractures, respectively.

Conclusions: The detection of fracture lines and visualization within the mandibular-maxillary area using

DVT was superior to using conventional radiographs.

58



Current status of monolithic zirconia in restorative

dentistry!

Aous Abdulmajeed

University of North Carolina, USA

I will be talking about monolithic zirconia. What is this restorative material? What are the mechanical,

optical and esthetic properties? How does it stand against other restorative materials available in the

market?

The scientific data presented in this talk will be based on my own research in this field, supported by other

references as well.

This presentation will help the audience to better understand monolithic zirconia as a restorative material and

hence better dental practice.

59



The Dentist’s role in treating Sleep Apnea and Snoring.

Jean Patrick Arcache

University of Montreal, Québec

Being a health issue of fundamental importance Obstructive Sleep Apnea has been a «hot topic» in

medicine as well as in dentistry for the last few years.

For better or worse, dentistry is embracing the subject. The purpose of the presentation is to review the

fundamentals in Anatomy, Pathophysiology and Epidemiology of the OSA and of course to present the latest

scientific evidences in the field of Dental treatment for Sleep Apnea and Snoring. The audience will be made

aware of the importance and pivotal role that dentists play a in the team treating OSA and how to optimize

it: The diagnosis for OSA in made by a Physician specialized in Sleep Medicine (Pulmonologist, ENT, Sleep

Physician) usually after a polysomnographic recording.

The dentist has a pivotal role in screening for Sleep Breathing Disorders, do a full and comprehensive

examination of the patient, refer to the physician and, if indicated, make impressions, fit an Oral Appliance,

do the adjustments required on this Appliance, monitor the progress of the patient and refer back for a control

titration. All these steps will be developed during the presentation.

Biography :Dr. Patrick Arcache is in charge of the Orofacial Pain Clinic at the University of Montreal faculty of Dental Medicine,

where patients with Temporomandibular Disorders, Orofacial pain, or Sleep Apnea are treated by the graduate students in

the department of Orthodontics. He also teaches Occlusion in the department of Orthodontics. A graduate of St-Joseph

University, he holds a certificate in Temporomandibular Disorders, Occlusion and Restorative, Dentistry from Georgetown

University in Washington D.C. Dr. Arcache focuses his practice on the treatment of Orofacial Pain, Craniomandibular

Disorders and Sleep Breathing Disorders. He had participated in many clinical studies at the University of Montreal,

Faculty of Dentistry, mainly in the field of O.S.A. He holds membership in numerous professional associations. Dr.

Arcache has lectured extensively on the subject of TMD and Sleep Apnea in North America, Europe and the Middle

East by presenting numerous lectures, conferences, and hands-on seminars on the subjects.He had served as an expert

in numerous professional cases for individuals, as well as insurance companies such as FARPODQ, SAAQ, CSST or the

Order of Dentists of Quebec.

60



Indications, Types, Advantages, Effects and the

Procedure per Se of Microdermabrasion

Arun Panda

Private Dentist, India

We, as cosmetic dentists, have done a fantabulous job of making our patients teeth look great

and giving them a healthy and beautiful smile and making them smile better than before.

Unfortunately, this intraoral arena of aesthetics does not complete the beautiful picture. It’s just

a part of the magnificent painting which the world sees. Inculcating the perioral structures would complete

the entire aesthetic dental picture that we are creating. Cosmetic dentistry shouldn’t commence and end

inside the lips. Teeth and gums need to fit into the entire framework of face. We as Cosmetic Dentists, can

give our patients, a more beautiful smile and face ,by incorporating certain procedures. Amongst other facial

aesthetic procedures like Botulinum Toxin injections, Dermal fillers injections, Mesotherapy, Chemical

Peeling etc., MICRODERMABRASION is the most simple but a very rewarding procedure which takes care

of ageing phenomena of the face and can drastically change the appearance of the face. Once incorporated

into our practice can change the way we look at our patients and the way world looks at the patient. In

our lecture, we would discuss about the indications, types , advantages, effects and the procedure per se of

MICRODERMABRASION and how we can incorporate this simple procedure into our practice to take it to

a higher level.

61



Essentials of Cleft and Craniofacial Care for General

Dentists

Ashok Utreja

Oral Health Sciences Center, India

Clefts of the lip and palate are the commonest of birth defects affecting the human face. According

to WHO, on an average 1 child is born with this anomaly among 600 to 1000 live births globally.

Total rehabilitation of a child born with cleft deformity involves a multidisciplinary approach, mainly

involving the Surgeon, Orthodontist, Dentist and the Speech therapist. Invariably the tissues directly involved

in a cleft deformity include the lip, alveolus, teeth and palate. Most of these patients have concave profile and a

deficient maxillary arch, varying degrees of malocclusion, missing or supernumerary teeth, malformed incisors

and occasionally a palatal fistula. With advances in cleft care the surgical, speech and dental components of

care keep changing. Complete rehabilitation of such patients starts in early infancy and goes on till adulthood.

The general dentist or the family dentist, at times may be approached by a patient with cleft deformity or the

parent of a child affected with cleft. It is therefore important that the general dentists have sufficient and up-

to-date knowledge of the various cleft care procedures and their timings, so that they may appropriately treat

and guide the patients with such deformities.

62



Perioperative management of dental surgery patients

receiving anticoagulants

Audrius

Vilnius University, Lithuania

The management of patients undergoing s dental surgery and receiving anticoagulants is challenging.

First, interruption of anticoagulation for a surgical procedure transiently increases the risk of

thromboembolism. Second, inadequate reversal of the anticoagulation effect may lead to severe

hemorrhage during surgical intervention. The presentation will review the current strategies for reaching

the balance between reducing the risk of thromboembolism and preventing excessive bleeding in individual

patient.

63



Temporomandibular Joint Internal Derangement: What

We Missed?

Ayman heagb

Al-Azhar University, Egypt

Temporomandibular joint internal derangement (TMJID) is the most common form of the TMJ

disorders with broad non-surgical and surgical treatment modalities. The results of these different

treatment modalities vary from study to study and from author to author resulting in confounding,

frustrating, and unremitting dilemma. In view of the fact that, the disease is multi factorial, while our vision

are constrained. TMJ-ID isn’t just a disc displacement, coexisting disease problem includes; myofascial pain,

mal-occlusion, clenching the teeth, the joint effusion, joint arthritis, change of Disc configuration, and LMP

abnormality. Then, to achieve a better treatment result, the multifactorial concept should be in our mind

with a broad vision to cover all aspects of the diseases process. Another important point, the success of the

treatment of TMJ-ID doesn’t depend only in treatment of the current joint problem. The treatment of the

underlying possible causes will result in long-term success.

64



Sleep to Nuts - what you need to know to get started

treating snoring and sleep apnea

Barry Freydberg

Dentist, USA

Course Description: This course gives the attendee an understanding of sleep apnea and the dentists’

role in its screening, diagnosis and treatment options. Additionally, the protocols for managing and

marketing sleep medicine within a practice will be identified.

Course Objectives for attendees: To enable them to decide how to add snoring and sleep apnea to their

dental practice. The attendee will understand the ethical and medically correct way to manage sleep apnea and

snoring. Know what tools are available to help diagnose and treat sleep apnea and snoring. To understand the

relationship of the dentist and sleep physician. To learn the vocabulary of sleep medicine. Understand the best

way to handle medical insurance billing

65



Ortho-Tmd-Sleep Connection

Brock Rondeau

Rondeau Seminars Ltd., United Kingdom

Dentists in the future must consider restructuring their practices towards helping their patients

achieve optimum health. This is accomplished in 3 ways. Over 70% of children ages 5-12 have

malocclusions. These must be treated early and by general dentists since the majority of orthodontic

clinicians prefer to wait until all the permanent teeth have erupted. Over 95% of children treated early with

functional appliances can be completed without the extraction of permanent teeth or orthognathic surgery.

Cases that should be treated include anterior and posterior crossbites, open bites due to tongue or thumb

habits, deep overbites and underdeveloped mandibles. Despite the fact that 32% of the adult population has

TM Dysfunction, only a small number of dentists feel qualified to treat these patients. It is my opinion

that TMD must be treated prior to any restorative, prosthetic or orthodontic treatment. In the treatment of

TMD it is critical to establish the ideal maxilla-mandible relationship transversally, sagittally and vertically

using lower indexed repositioning splints during the daytime. TMD patients must also wear upper anterior

deprogrammer appliances to prevent clenching and bruxing at night. Patients who snore and who have sleep

apnea are prone to high blood pressure, heart attacks, strokes, Type 2 Diabetes, acid reflux, depression, sexual

dysfunction and personality changes, memory loss and impotence. It has been estimated that over 50% of the

adult population snore and 20% have sleep apnea. Oral appliances are much better accepted by the patient

compared with the CPAP device and are considered to be the first treatment option for snoring and mild to

moderate sleep apnea. They are extremely effective in establishing a patent airway to prevent snoring and

sleep apnea by gently moving the lower jaw and tongue forward. With less than 1% of the dentists trained to

treat these patients this is an excellent opportunity for general dentists to get involved in not only prolonging

the lives of their patients but also improving the quality of their lives.

Biography :Dr. Rondeau is one of North America’s most sought after clinician who has been lecturing over 100 days per year for 35

years. He is the past president and senior certified instructor for the International Association for Orthodontics. Over

20,000 dentists have attended his courses and study clubs in the United States, Canada, China, Australia, England, Poland,

and Turkey. He has an extremely busy practice, which is limited to the treatment of patients with orthodontic, orthopedic,

TMD, and snoring and sleep apnea problems. Dr. Rondeau is a Diplomate of the International Board of Orthodontics, a

Diplomate of the Academy of Clinical Sleep Disorders Disciplines, a Diplomate in the American Academy of Craniofacial

Pain, a Diplomate in the American Academy of Dental Sleep Medicine, and a Diplomate in the American Academy

of Craniofacial Dental Sleep Medicine. He has published over 30 articles in orthodontic and dental journals and has

produced a series of videotapes on all phases of orthodontics as well as extensive internet courses in Orthodontics, TMD

and Snoring and Sleep Apnea. Dr. Rondeau has also written two chapters in medical and dental textbooks; one on early

treatment and functional appliances and another on oral appliance therapy for snoring and sleep apnea.

66



Common Errors in the Management of

Temporomandibular Disorders

Daniel M. Laskin

Medical College of Virginia, USA

When problems occur following management of various temporomandibular disorders (TMDs)

clinicians often rely upon complex explanations of why they occurred. However, experience

has shown that most of these problems are due to simple things that were either overlooked or

forgotten. This presentation will focus on understanding and preventing the most common mistakes that

clinicians make when treating TMD patients.

67



Ideal composite selection in aesthetic functional

restorations

Daniele Rondoni

Private Dentist, Italy

The detailed analysis in aesthetic dentistry, determined an evolution in the development of the materials,

improving mechanical properties and optical features in order to obtain an ideal mimetism in dental

restoration respecting aesthetic and function according to the new concept EFP ABS The choice of

the ideal material is certainly the base of the result; therefore the clinical-technical analysis is important to

determine the individual strategy to be used for each patient, being the conservative restoration the excellent

solution. It is important to have at disposal a range of material that allow to perform an anatomic stratification,

that in combination with the light can imitate the effect and the behavior of the natural tooth. Therefore for

front teeth sectors it is fundamental to use a nanohybrid composite with high refractive index like that it is

also ideal for the flexural strength necessary for anterior partial restoration like veneers. Thanks to modern

dental knowledge, nowadays it is possible to say that the balance and occlusal stability is patient is the most

precious benefit that the dentist must preserve or, in case of dysfunctions, recover. The dentist has at his

own disposal new diagnostic tools and a lot of new restorative materials for conservative restorations and

prosthetic solutions with high aesthetic quality and the material selection must consider also the mechanical

physical properties.

68



Facial enhancement using biomimetic oral appliance

therapy in Korean women.

G. Dave Singh

BioModeling Solutions Inc., USA

Biomimetic oral appliance therapy (BOAT) has been shown to have beneficial effects in adults with mild,

moderate and even severe obstructive sleep apnea (OSA). In addition, this non-surgical, pain-free

technique, which does not use drugs or injections has other effects while treating OSA, such as increased

midfacial bone volume. Therefore, the aim of this study is to test the hypothesis that facial enhancement can

be achieved using BOAT in Korean adults. After obtaining informed consent, 12 adult females (mean age

= 29yrs ± 3) underwent BOAT by a dentist (KYK) with advanced training in the BOAT technique. The

following mean craniofacial parameters were measured on standardized frontal and lateral photographs pre-

and post-treatment: Intercanthal angle; inter-pinnal angle; frontonasal angle; nasolabial angle; labiomental

angle, and thyromandibular angle. The findings were subjected to statistical analysis, using paired t-tests.

Results: The mean intercanthal angle changed from 11.90 ± 3.4 to 13.10 ± 4.7 (p > 0.05); The mean inter-pinnal

angle changed from -0.40 ± 2.5 to 0.020 ± 1.9 (p > 0.05); The mean frontonasal angle changed from 137.00 ±

5.9 to 137.50 ± 8.2 (p > 0.05); The mean nasolabial angle changed from 86.70 ± 12.6 to 86.10 ± 10.1 (p > 0.05);

The mean labiomental angle changed from 126.30 ± 11.3 to 134.00 ± 7.3 (p < 0.01); The mean thyromandibular

angle changed from 126.50 ± 11.2 to 118.60 ± 14.3 (p < 0.01). This study supports the notion that BOAT may

be successful in enhancing facial appearance non-surgically in adult female Koreans. Further studies are

needed to determine whether these anti-aging facial improvements can be maintained.

Biography :Dr. Dave Singh was born, educated and trained in England, UK. He holds three doctorates, including a Degree in Dental

Surgery; a Ph.D. in Craniofacial Development, and a D.D.Sc. in Orthodontics. At the Center for Craniofacial Disorders,

USA, he led a NIH-funded program of craniofacial research. Currently, he is a Member of the World Association of Sleep

Medicine and American Academy of Dental Sleep Medicine; and Fellow of the World Federation of Orthodontists, and

International Association for Orthodontics. He has published numerous articles in the medical, dental and orthodontic

literature, and has lectured in North America, Asia, Europe and Australia.

69



Dentistry and Psychiatric Illness: Challenges to Oral Care

David Clark

Ontario Shores Centre for Mental Health Services, Canada

Psychiatric illness and its medical management carry significant risks for oral disease. Although mental

illness is common, in many cases it is misunderstood, remains unrecognized, or is undertreated. Mental

illness and the resulting disabilities create difficulties not only for the patient but also for one’s family and

friends, not the least of which remains the highly stigmatized nature of the disease itself. Understanding the

type, severity, stage of mental illness, along with a patient’s own mood, motivation and personal perceptions

of oral disease and lifestyle can enhance the knowledge of dental professionals concerning this critical aspect

of a patient’s medical history and further illustrates how closely mental health and oral health are intertwined.

Mental illness must be viewed from a similar perspective as are other major diseases. Dental professionals

should be aware of factors such as the reduced rates of compliance with dental treatment, reduced ability to

access oral health care, the effects of various psychotropic medications on oral health including xerostomia,

caries and periodontal disease and the potential interactions withdrugs used in dental practice. Patients with

psychiatric illness often bring unique needs and differing priorities to a dental practice, and the dental health

practitioner must in turn demonstrate patience, flexibility, empathy, and a non-stigmatizing attitude in caring

for these individuals. Enhancing self-esteem and feelings of self-worth for those coping with a psychiatric

illness can be a very fulfilling experience that can only serve to continue to break down the stigma surrounding

this group of diseases

70



When is vital pulp therapy preferable to root canal

treatment: a changing pattern of treatment modalities

Dimitrios Tziafas

European University College, Dubai, UAE

Vital pulp therapy aims to maintain pulp vitality and restore the integrity of circumpulpal dentin

whenever the dentin-pulp complex is damaged by physical, mechanical or bacterial injuries. Four

vital pulp therapy techniques are used in today clinical practice: pulp protection, indirect pulp

capping, direct pulp capping and pulpotomy. Qulaity clinical research and recently published systematic

reviews showed an insufficient grade of evidence concerning the therapeutic validity of today vital pulp

treatment modalities in comparison with the orthograde root canal treatment. On the other hand, extensive

background and translational research during the last two decades described the biological mechanisms

underlying the healing and/or regeneration potential of the pulp-dentin complex and opened new directions

to the scientists to devise more realistic therapeutic strategies for the long-term preservation of functional

pulp-dentin complex. Novel regenerative treatment strategies are based on the recognition that the nature

of the biological mechanisms by which the traumatized pulp-dentin complex is therapeutically healed

determine the properties of the regenerative tissue and therefore play a critical role in the outcome of dental

treatment. This critical review focuses on an evidence-based reference for clinical indications of today vital

pulp treatment modalities and the healing and/or regeneration potential of the pulp-dentin complex, which

seems to offer exciting therapeutic opportunities for the future endodontics.

Biography :Dimitrios Tziafas is Professor of Endodontics and Director of the Master of Science in Endodontics Program of European

University College at Dubai, DHCC, UAE. He served as Head of the Department of Endodontology at the School of

Dentistry, Aristotle University of Thessaloniki (1999-2013) and Chairman of the Postgraduate Program of School of

Dentistry, Thessaloniki, Greece (2007-2013). Dr Tziafas worked as a visiting researcher in the Institute Biologie Medicale,

Faculte de Medecine, Universite Louis Pasteur, Strasbourg, France, and served as the National Representative of Greece

in European Committee research networks. He was a board member of the IADR/Continental European Division and

served as the President of IADR – Continental European Division (2006-2008). He is member of Research Committee

of European Society of Endodontology. Dr. Tziafas’ research interests include biology of dentin-pulp complex and

regeneration and pathogenesis of pulp inflammation. He has published eight invited reviews in internationally-recognized

biomedical and dental journals, over 50 peer-reviewed research papers, and textbooks chapters or monographs relating

to pulp biology, while he has been Guest Editor of the Journal Advances in Dental Research, Volume 15, 2001, on Dentin

repair and regeneraton. .

71



Failure modes and prevention of NiTi rotary instruments

Fouad Abduljabbar

King Abdulziz medical city, Saudi Arabia

For 15 years, NiTi rotary instruments become an essential part of endodontics. Fractured instruments

interfere the goals endodontic therapy. Instrument fracture may adversely affect the success rate of

endodontic treatment. Many researches have been undertaken to understand the mechanisms of

failure of NiTi instruments to minimize its occurrence. Factors related to clinician experience, technique, and

competence have been shown to be influential. From an assessment of the literature presented and clinical

cases, clinical recommendations are derived concerning prevention and management of this complication.

The purpose of this presentation is to present points that clinical operators can take to reduce the risk of NiTi

rotary instrument failure and prevent fracture during root canal preparation.

Biography :Dr. Fouad abduljabbar is a consultant endodontist, director of dental supplies and materials and equipment of endodontics

department, member of dental supplies and materials andequipment committee, coordinator of endodontic department,

clinical supervisor of saudi board dental student dental interns, dental services, west region, king abdulaziz medical

city, the ministry of national guard, jeddah, saudi Arabia. He has completed his Dental Surgery Clinical certificate in

Endodontics at The University of Hong Kong, 2009 bachelor of Dental Medicine surgery at King Abdulaziz University,

2003. He is author of some scientific articles in reputed journals. Also presented number of dental lectures, as well as

dental courses in out of Saudi Arabia.

72



From Apical Surgery to Periradicular Microsurgery: A

New Era in Conservative Therapy, a New Dimension in

Endodontics

Gabriele Pecora

University of Guarulhos, Brazil

In the last 30 years Endodontics has changed its rules and regulations. The use of new instruments and

materials has elevated the capability of Clinicians to treat difficult and border-line cases. The utilization

of Surgical Operative Microscope led the treatment to the excellence of endodontic pathologies and has

widened the area of surgery from the apex to the whole root surface. The introduction of GTR principles

has opened a New Dimension on the diagnosis as well as in the prognosis of border-line cases,. Today the

dilemma is Tooth or Implant and the new challenge is : Bone Regeneration, Bone Preservation.Bone Quality.

This presentation will be an overview on the state of art of surgical therapeutic options for conservative tooth

treatment.

73



Pena-Shokeir syndromeCase Report of an Infant, and

Review of Literature.

Gazalla K. Agalit Jordan

University of Science and Technology,Jordan

Pena-Shokeir syndrome is a rare progressive congenital syndrome described by S D J Pena and M H K

Shokeir in (1974)1. We present a literature review of the syndrome, and report a case of 1.5 month

old, Libyan male who have Pena Shokeir syndrome. Family history of the infant revealed that his elder

brother have the same syndrome; both of them are still alive.

Biography :Dr. Gazalla K. Agali started part time teacher at JUST from 16-2-2014 until 6-9-2014. From 7-9-2014 he had contract with

this school for one year. He is working at the pediatric department teaching 4th year, 5th year, lectures, and clinical teaching.

Dr. Gazalla also has one day privet at Irbid dental center as a school request. He is Consultant in pediatric dentistry.

his objectives are training students to be able to treat the children, and provide a primary health dental care for the

children. Clinical researches in pediatric dentistry.

74



From periodontal downs to esthetic heights – a

periodontally driven restorative concept

Gerd Körner

No doubt, the natural tooth in its sane and biologically stable surroundings is the best situation we

are looking for with our patients and try to preserve it as long as possible. Anyhow this conservative

approach is the back bone of cost effective excellence in dentistry.

But very often in our daily practice we are confronted with tooth loss and periodontal break down so that we

have to think about strategies to restore the damaged dental excellence. Especially the combined perio – dental

defect usually was treated by filling it up by inert restorative materials calling it perio – prosthodontics. By

definition this is a double term that should be interpreted in an adequate way. With modern techniques and

materials we should assume a new perception of this old problem and try to recreate the damage depending

on the original elements. That means for example to replace a missing tooth by a pontic as part of a denture or

an implant. But the damaged and reduced surroundings should be corrected in a biologically appropriate way

by preserving the natural structures as far as possible or reconstructing it in an easy and feasible way.

The presented periodontally driven concept is intended to elucidate possibilities to achieve dental excellence

even in compromised situations respecting at the same time natural surroundings and cost effectiveness.

Biography :Dr. Gerd Körner qualified with a BDS from the University of Münster in 1975. Following a 18 months staying with the

German Military Services as a general dental practitioner he returned to an advanced gradual residency program in

Periodontics and restorative dentistry at Münster University. Since 1981 he runs a renowned private practice in Bielefeld

specialized in periodontics and perio- prosthodontics including implantology and particularly complex aesthetic cases.

After publishing his first text book “ArtOral” together with Klaus Müterthies in 1996 he became a board member of

different clinical journals and in 2007 he was appointed as a faculty member of the German Society of Periodontology for

“Master of Science in Periodontology and Implant Treatment”. He has a number of publications to his name on the subject

of minimal- invasive dentistry concerning especially periodontally compromised cases. His last text book “ArtOral: Non

- Invasive, Minimal - invasive, Invasive” published by Quintessence in 2011 together with Klaus Müterthies highlights

modern restorative concepts in periodontal and implant treatment. In 2015 he was appointed to be an active member of

EAED (European Academy of Esthetic Dentistry).

Since 1990 he has been lecturing for different dental institutes in the field of periodontics and implantology worldwide and

has been keynote speaker to numerous national and international dental, scientific congresses.

75



Diabetes and Periodontal Disease

Ghadir Atout

Boston University, USA

Diabetes Mellitus is a group of metabolic disorders with the common characteristic of altered glucose

tolerance or impaired lipid and carbohydrate metabolism due to defects in insulin secretion,

action, or both. Major symptoms of high blood glucose are; polyuria, polydipsia, weight loss,

sometimes with polyphagia, and blurred vision. Susceptibility to infections may also accompany chronic

hyperglycemia. Long-term complications of diabetes include retinopathy, nephropathy, neuropathy, micro

and macro vascular injuries, altered wound healing and periodontal disease. Patients with diabetes have an

increased incidence of hypertension and abnormalities of lipoprotein metabolism. Epidemiologic evidence

suggesting a higher prevalence of diabetes raises a flag towards serious preventive measures; otherwise the

prevalence will continue to increase Possible mechanisms of hyperglycemia induced complications include

aldose reductase pathway (polyol pathway), the advanced glycation end products (AGE) theory, generation of

reactive oxygen intermediates and protein kinase C activation Periodontal disease has been identified as the

sixth complication of diabetes. The severity of periodontal disease is increased in diabetes patients. Factors

such as, Glycemic control and the development of diabetic complications like neuropathy or the presence

of inflammatory risk factors such as smoking and poor oral hygiene are highly related to the increase in the

incidence of periodontal disease . Leukocyte defects have been implicated in the development of periodontal

disease in diabetes. That includes increased susceptibility to infection, resulting in impaired chemotactic,

phagocytic and bacterial killing mechanisms. There is evidence that neutrophils from diabetes are primed

and this priming leads to tissue damage associated with the pathogenesis of periodontal disease. The extent

of priming correlate with the extent of periodontal disease and diabetic control as assessed by glycosylated

hemoglobin (HbA1c) levels.

Biography :Dr. Atout completed her specialty training with honors in Periodontology and Dental Implants at Boston University

Goldman School of Dental medicine; She received “Stallard Award” as top Periodontology resident. She also obtained a

Masters of Science in Dentistry and Oral Biology from Boston University. Dr. Atout practiced Dentistry, Periodontology

& Dental Implants for over 15 years in the USA and Middle East. Dr. Atout also has an interest in Academics and research;

she worked on Periodontology and oral biology research at the Forsyth Institute; a Harvard affiliated research Institute

with world-renowned Periodontists and educators. Dr. Atout has received her National Dental Boards and Western Dental

licensing Boards in the US (NBDE Part 1&2, WREB), as well as the eligibility written exams for the American Board of

Periodontology. She is an active member of the American Academy of Periodontology as well as the American Dental

Association.

76



Articaine and mepivacaine buccal infiltration in securing

mandibular first molar pulp anesthesia following

mepivacaine Inferior alveolar nerve block: A randomized

double-blind crossover study

Giath Gazal

Taibah University, Saudi Arabia

Aims: A crossover double-blind randomized study was designed to explore the efficacy of 2%

Mepivacaine with 1:100,000 adrenaline buccal infiltration and 4% articaine with 1:100,000 adrenaline

buccal infiltration following 2% mepivacaine with 1:100,000 adrenaline inferior alveolar nerve block

(IANB) for testing pulp anesthesia of mandibular first molar teeth in adult volunteers. Methods and Material

:Twenty three healthy adult volunteers received two regimens with at least one week apart; one with 4% articaine

buccal infiltration and 2% mepivacaine IANB (articaine regimen) and another with 2% mepivacaine buccal

infiltration supplemented to 2% mepivacaine IANB (mepivacaine regimen). Pulp testing of first molar tooth

was electronically measured twice at baseline, then at intervals of 2min for the first 10min, then every 5min

until 45min post injection. Anesthetic success was considered when two consecutive maximal stimulation on

pulp testing readings without sensation, were obtained within 10min and continuously sustained for 45min

post injection. Results: In total, the number of no sensations to maximum pulp testing for first molar teeth

were significantly higher after articaine regimen than mepivacaine during 45 minutes post-injection (267 vs.

250 episodes respectively, p < 0.001), however, both articaine and mepivacaine buccal infiltrations are equally

effective in securing anesthetic success for first molar pulp anesthesia when supplemented to mepivacaine

IANB injections (p>0.05). Interestingly, volunteers in the articaine regimen provided faster onset and longer

duration (means 2.78 min, 42.22 min respectively) than mepivacaine regimen (means 4.26 min, 40.74 min

respectively) for first molar pulp anesthesia (p<0.001). Conclusions: Supplementary mepivacaine and

articaine buccal infiltrations produced similar successful first molar pulp anesthesia following mepivacaine

IANB injections in volunteers. Articaine buccal infiltration produced faster onset and longer duration than

mepivacaine buccal infiltration following mepivacaine IANB injections.

77



Early Childhood Caries and the new findings

Hamidreza Poureslami

Kerman University of Medical Sciences, Iran

Early childhood caries (ECC), also named as rampant caries or baby bottle syndrome is one of the most

prevalent chronic childhood diseases. It is described by the presence of one or more decayed, missing,

or filled tooth surfaces on any primary tooth in children up to 71 months of age. There are different

preventable factors which make the child susceptible to ECC. This disease has many effects on the child’s

health. It can cause lots of functional problems and also has negative effects on the child’s quality of life.

According to the negative outcome of this problem, it is necessary to know the risk factors of this disease. It

can help us find impressive ways to prevent ECC. The aim of this article is introducing the etiologic factors of

ECC and also recommending new methods to prevent it. Information included in this article is achieved by

PubMed search and covers the data from 1971.

Biography :Dr. Hamid Reza Poureslami Graduated from Dental School, Kerman University, Kerman, Iran in the year 1986, he had

completed his General Dentist degree from Dental faculty, Beheshti University, Tehran, Iran. In the year 1999 he had done

his Specialization in Pediatric Dentistry Dental Faculty, Mashhad University. Dr. Hamiid Reza Poureslami was Participate

in 15th course of examinations of the National Board in Iran and board certified in Pediatric Dentistry. Previous he had

worked as Dental Hygienist. Currently he is working as Professor in Pediatric Dentistry department at Kerman Dental

School, Iran.

78



Autotransplantation of 118 One Rooted Premolars. An

Evidence Based Treatment Possibility Of Tooth Loss And

Hypodontia As Well As Ectopic And Impacted Teeth.

30 Years Long-Term Evaluation, All Treated By the

Presenter

H U Paulsen

Municipal Dental Health Service, Denmark

Objective of this study was to present the possibilities and long-term evaluation of survival and failures

of autotransplanted premolars, followed more than 30 years. Materials and Methods: This study

investigated a consecutive group of one hundred patients treated with autotransplantation caused

tooth loss, hypodontia and ectopic tooth position. All patients (9.2-14.4 years, mean 12.8), 53 boys and 47 girls,

had one-rooted premolars transplanted from one region to another. Totally 118 premolars were transplanted

in root stages with an open apex wider than 1 mm. Primary healing and follow-up were tested using a Siemens

electrometric pulp tester to detect pulpal reinnervation and standardized radiographs to test transplant healing

and root development generally. Assessments were carried out at 1, 4, 8, 12 and 24 weeks and thereafter

yearly after transplantation. Tooth eruption and root development was evaluated using a color coding technic,

developed at the Karolinska Institute, Stockholm. Transplants were moved or rotated orthodontically 3-9

months after transplantation. Results: Complicated problems were moved to other regions or replaced, easier

to solve orthodontically. Most transplanted premolars showed normal tooth eruption, compared with contra

laterals. Transplants induced tooth eruption and bone induction. Transplants erupted before visible root

formation and before visible alveolar bone formation. Furthermore, marginal gingiva was transferred with

both papillae. It was found successes of 91.5% and failures of 8.5% for all transplants. Premolars transplanted

as maxillary incisors had a higher incidence of failures (15%) than premolars transplanted to the mandibular

premolar regions (7.6%). Conclusion: Marginal gingiva was transferred with both papillae. Transplantation

induced tooth eruption and bone induction. Transplantation of one-rooted premolars carried out by a trained

oral surgeon had a long-term survival of 91.5% - even transplants were moved or rotated orthodontically 3-9

months after surgery. The method can therefore be taken into account in the orthodontic treatment planning.

AAO Presentation: Autotransplantation in orthodontic treatments, biology and development of tooth hard

and soft tissues, surgery, orthodontic treatment, tooth rotation and long-term survival and failures observed

more than 30 years after surgery in patients, all cases planned and orthodontic treated by the AAO presenter.

79



Common Complications and solutions in dental

implantology

Helme Altaee

Private Dentist, United Arab Emirates

The use of dental implants to restore missing teeth has steadily increased over the past three decades.

It is perhaps not surprising, then, that the number of implant-related complications has grown as

well. Numerous clinical studies involving dental implants have revealed encouraging outcomes;

however, there is an element of risk associated with all clinical procedures, and these encouraging results may

have given rise to unrealistic expectations. Despite careful planning, there is always a potential for surgi cal

complications. Nevertheless, carrying out routine tasks with care and attention, choosing minimally invasive

techniques when indicated, recognizing evidence of a developing problem and giving prompt attention will

reduce postoperative and prosthetic complications. The successful outcome of any surgical and or prosthetic

procedure requires attention to a series of patient-related and procedure-dependent parameters. Sound

knowledge of surgical anatomy and experience and training in the prosthetic dentistry and implantology are

important prerequisites for predictable implant surgery. Also, adequate presurgical planning, good primary

stability, a sufficient healing period, and detailed postoperative in structions are all factors that play a vital role

in the success of dental implant surgery and osseointegra tion. Aging, changing health conditions, wear and

tear, and inadequate professional maintenance are important variables influencing prognosis. Some hints that

we can follow will avoid us many unwanted future complications.

Biography :Dr. Helme altaee is a consultant maxillofacial surgeon and dental implantologist , post doctorat degree in dental

implantology, athens/greece- january 2013, PhD dental implantology and biomaterials, 2004, university of athens-greece

(1999-2004) with grade excellence , high diploma degree in maxillofacial traumatology and corrective orthognathic

surgery dept. of traumatology, aglaia kyriakou hospital (athens-greece, 2000-2003), m.sc. oral and maxillofacial surgery,

1992, dentistry college-university of baghdad (1990-1992) with grade, bachlor of dental surgery (b.d.s), 1987, graduated

from dentistry college- mosul university, iraq (1983-1987), rank 1st with grade good.

80



Retiform Hemangioendothelioma in Infratemporal

Fossa and Buccal Area: A Case Report and Review of the

Literature

Il-Kyu Kim

Inha University Hospital, South Korea

Objective: We report a case of retiform hemangioendothelioma(RH) in a 13-year-old Korean boy,

which located at the infratemporal fossa and the buccal area. This tumor was originated from

sphenoid bone of infratemporal fossa area and spread into the cavernous sinus, the orbital apex, and

the retro nasal area occurring bone destruction of pterygoid process.

Methods: Case report and literature review. Magnetic resonance images were taken and an intraoral incisional

biopsy of buccal area was performed before surgery. Tumor resection was conducted by Le-fort I osteotomy

and partial maxillectomy to approach the infratemporal fossa and retronasal area. The diagnosis of RH was

confirmed after surgery.

Results: RHs originate from not only the superficial vessels of the body but also the deep vessels like sphenoid

bone of infratemporal fossa area which has an anatomically high vascularity. Surgical excision was incomplete

and close follow-up have been done. There were no evidences of expansion or metastasis of the residual tumor

for 8 years after surgery.

Conclusion: In case of that the residual RH would not expand and metastasize, even though its intermediate

malignancy, only the close follow-up could be more appropriate treatment choice than the additional

aggressive therapy. This RH is the second case as primary bone tumor and the first case which originated in

or maxillofacial area.

81



Ultrastructural and quantitative investigations on the

response of pulps using different growth factors when

combined with mineral trioxide aggregate or Calcium

Hydroxide

Khalid S Al-Fouzan

King Saud Bin Abdulaziz University, Saudi Arabia

The demand for predictable treatment modalities in regenerative medicine continues to escalate as

researchers seek to gain a better understanding of the cellular and molecular mechanisms involved in

regeneration and as clinicians seek more predictable outcomes and user-friendly techniques. Further

development of this powerful protein therapeutics has been achieved by combining them with tissue-specific

biomaterials to provide a substrate for new tissue regeneration as well as an ability to attenuate release of the

recombinant growth factor. To appreciate the significance of this new class of regenerative therapeutics, it is

helpful to understand the basis for their emergence.

Biography :Khalid S Al-Fouzan, Is an Associate Professor and the Associate Dean of Academic Affairs, at King Saud Bin Abdulaziz

University, Dental School, since December 5, 2010. He is also the founder and the past president of the Saudi Endodontic

Society for the period, April 2010 to, April 2013. He is also a member of the Saudi Board in Endodontic for Health

Specialties, Scientific committee, since March, 2005. He is also the director of the Endodontic Board for Health Specialties

in KADC-KAMC, NGHA, since 2007 and the division Head, Endodontics, KADC-KAMC, NGHA, for the period of April

2004- Nov 2013. Dr. Al-Fouzan is a diplomat of the American Board of Endodotics, since 2002. Dr. Al-Fouzan got his

certificate in Endodontics, from University of Southern California, in July 1998 and a Master in Dental Education, from

the same school in May, 1997. Dr. Alfouzan got his undergraduate training from King Saud University in Jun, 1992 and he

has several publications in a will recognized journals.

82



The true cost of implant failureMajd Al Mardini

Univesity of Toronto, Canada

The talk deals with the monetary and the intangible (reputation) cost of complication or failure to the

clinician. The lecture present a model developed from data collected from clinician to illustrate the true

cost of failure in our every day practice.

83



MicroRNAs (miRNAs ) powerfull regulators of the

transcriptome and canditates for additional treatment in

dental diseases

Maria A. Landin

Oslo Univesity, Norway

Understanding the genetic processes that govern murine tooth development by mapping the global

murine mRNA transcriptome and their regulators miRNAs may provide new bio-therepeutic tools in

dentistry. MicroRNAs have a short life span however these small molecules regulate messenger RNAs

(mRNA) in mamals. In turn mRNAs translate into proteins. Previous research focus has been on identifying

one or more target proteins that can be used as a diagnostic tool and to find the most successful treatment. By

understanding genetic events and regulation mechanisms during murine tooth development may provide bio-

tools for dentists and influence positively the clinical outcome in persistent infectious cases like periodontitis

or perio-implantitis. For many patients with persistent infectious conditions with loss of bone and eventually

loss of teeth may benefit of additional treatment approaches. In addition extrapolation of genetic studies may

contribute to increase knowledge on the numerous biological events in regeneration and healing processes of

oral soft and hard tissues generating additional treatment strategies and give predictable results in restoration

treatment after oral infections resistent to clinical treatment.

Biography :Dr Maria A. Landin is a toxicologist, specialized in toxicogenomics, working with Prof Harald Osmundsen at the institute

for Oral Biology. During her PhD, she investigated and mapped the global gene expression in murine tooth buds using

molecular biological methods. This lead to creation of a microarray database (68 microarrays) entailing 16 time points

of murine tooth development from the embryonic day 11th up to 7 days post-partum (E11.5- P7). During her degree

she aquired knowledge and skills in molecular biological techniques such as microarrays, real-time RT-PCR, isolation

of proteins or RNA / DNA from tissues or cells. She also masters various immunological techniques and has extensive

experience in animal experiments and microdissection. She established In Situ hibridisering (Ribo-and oligoprober) at the

institute and participated in several projects looking at the effects of brominated and / or perfluorinated flame retardants

in wild type and knockout mice. She also colaborated with the biofilm groupe at the institute, where microarrays with up

to 30K oligo were used to assess the toxicity of furanone in vivo.Currently Dr.Landin researches on the rolle microRNAs

(miRNAs) in the regulation of the murine transcriptome using loss of function studies.

84



Digital Dental Photography; the science and the art

Moataz Samir Eliraqi

Private Dentist, Qatar

The cosmetic dentistry is increasing everyday and with a bigger market higher standards are always set.

Digital dental photography is at the heart of the cosmetic dentistry. Diagnosis and treatment planning

is much easier using photos and grids. Higher possibility of patient saying yes to the treatment plan

when using photos and photo editing provide an after preview before starting . Of course case documentation

and medicolegability. Using photos of previous patients is an invaluable marketing tool In order to take the

right photos; the dentist needs to understand basic photography rules, and know the right settings, angles, etc.

for each of the required photos.in part one of this lecture we will cover the basic photography definitions and

settings and show how each affects the picture taken In part two we will cover the required intra and extra oral

photos for a full diagnosis and smile design.

Biography :Moataz Eliraqi is a restorative and cosmetic dentist practising in Qatar. After receiving his bachelor’s degree in 2000,

he took a residency program and finished his master’s degree both in restorative dentistry, followed by a diploma in

healthcare administration. Besides his work in both private and public sectors in Egypt; he worked as a staff member at

Pharos University for a year before moving to Qatar. He’s a member of the American Academy of Cosmetic Dentistry.

85



Stem Cell Bone Allografts in Maxillary Sinus and Ridge

Augmentation, Report of a case

Mohamed A Maksoud

Harvard University School of Dental Medicine, USA

Maxillary sinus and ridge augmentations were performed using an allograft cellular matrix containing

live stem cells. The results were evaluated via a postoperative CT scans and periepical radiographs.

The sinus augmentation was evaluated in 10 weeks in which the radiographic bone tomography was

similar to that of the native bone and the ridge augmentation resulted in a 3-4mm vertical ridge augmentation.

Even though histological examination was lacking, the clinical and radiographic findings of the case were

promising. This presentation will show the clinical and radiographic documentation in addition to discussing

the potential benefits of stem cell bone matrix with its future promises.

86



Spatial analysis of infant mortality in the governorate of

of Kafr El-Sheikh, Arabic Republic of Egypt - Study on

the geography of population

Doaa Ahmed Awad Mustafa

Kafr El-Sheikh University, Egypt

The results of the study showed that factors in infant mortality in the governorate of Kafr El-Sheikh,

as follows: First factor) genetic diseases( this factor explained about 33.52% of the total variance in

the matrix of variables, this reference which (more than 1) which means the impact force on infant

mortality in Kafr El-Sheikh governorate in Arabic Republic of Egypt. The second factor) septicemia( this

factor explained about 25.21% of the total variance in the matrix of variables, this reference which (more

than 1) which means the impact force on infant mortality in Kafr El-Sheikh governorate in Arabic Republic

of Egypt. The third factor) Mitt baby( this factor explained about 13.11% of the total variance in the matrix

of variables, this reference which (more than 1) which means the impact force on infant mortality in Kafr

El-Sheikh governorate in Arabic Republic of Egypt. The fourth factor) prematurity) be ( born early schedule

or incomplete development) this factor explained about 9.23% of the total variance in the matrix of variables,

this reference which (more than 1) which means the impact force on infant mortality in Kafr El-Sheikh

governorate in Arabic Republic of Egypt. The fifth factor ( as a result of negligence by the General Hospital )

this factor explained about 4.21% of the total variance in the matrix of variables, this reference which (more

than 1) which means the impact force on infant mortality in Kafr El-Sheikh governorate in Arabic Republic of

Egypt. Field study of infant mortality in Kafr El-Sheikh governorate of the Republic of Egypt Arabic, factorial

(0-1), ( more than 1) (0-1), that the impact of these variables are less influential, and it was simply focusing on

these five factors in the study’s recommendations. Interest in improving health status and socio-economic role

in worsening the preparation of infant mortality in Kafr El-Sheikh governorate in Arabic Republic of Egypt.

Interest in the housing sector and to provide more housing units, and the provision of services to existing

housing units, as well as health services at government hospitals, which may have an impact on the growing

number of infant mortality in Kafr El-Sheikh governorate in Arabic Republic of Egypt.

87



Progressive immediate implant loading in the posterior

of maxilla followed by resonance frequency analysis

Mohammed jasim Al-juboori

Private Dentist, Iraq

According to Lekholm and Zarb, the bone density of the posterior maxilla is classified as type 4 bone,

which means that a thin layer of cortical bone surrounds low-density trabecular bone. Implants placed

in soft bone or D4 bone require a longer healing period for better bone remodeling and maturation.

A poor bone density does not provide support for the implant during the healing and loading stages. Higher

implant failure rates have consistently been found in areas of poor bone quality, such as the posterior segment

of the maxilla. There are several special considerations that should be taken into account when implants

are placed in the posterior maxillary area, including drilling an undersized preparation to obtain primary

stability, using a modified (roughened) implant surface, using a wide diameter and aggressively designed

implant, and using a submerged technique to avoid implant loading stress. All of these measures result in

an increased implant surface area that enhances bone implant contact and implant stability. The progressive

implant loading technique was developed by Misch for implants placed in areas with poor bone density. This

technique allows bone to mature during the loading period without overloading the implant and resulting in

bone loss or implant failure.

88



The comparison of chlorhexidine solution and swab

with toothbrush and toothpaste effect on preventing oral

lesions in hospitalized patients in intensive care unit

Alinejad M

Sabzevar University of medical sciences, Iran

Introduction: Maintaining oral hygiene has been one of the basic responsibilities of nurses working at

intensive care units. This study aimed to compare the relative effectiveness of chlorhexidine solution and

toothbrush in the prevention of oral lesions or ulcers in different parts of the mouth.

Method and materials: In this clinical trial study, the research population included patients hospitalized with

endotracheal tube in intensive care unit. In this study, a purposeful sampling procedure was initially used to

select some 30 patients who were, then, randomly assigned to two different groups of toothbrush-toothpaste

and chlorhexidine using permutation blocking method. The modified form of Beck Oral Assessment Scale

(BOAS) and MPS were used to obtain the necessary data. Data were analyzed by means of R software

(version3.0.2) and also multiple logistic regressions in the confidence level of 95%.

Results: this study indicated an association between using toothbrush and the oral health level (OR: 1.52). In

different parts of the mouth, there was no statistically significant difference between the two groups in terms

of the prevention of lesions in gums, lips and tongue. However, there was a significant difference between

the two groups in terms of plaques, mucus and teeth with an odd ratio of 3.94 for teeth and 2.75 for mucus

. In comparison, there was a close relationship between implying chlorhexidine and saliva health level. (OR:

2.046).

Conclusion: The findings of the present study showed that using toothbrush has a positive effect on declining

oral lesions in various parts of the mouth.

89



“Moving towards a Finer Way of Doing Dentistry” Silver

Nanoparticles: Properties and Application in Restorative

Dentistry

Mona Ismail Riad


Secondary caries is one of the major reasons for failure and replacement of restorations that occurs as

results of microgaps at the interface of restorations and allow invasion of fluids and bacteria. Of all

microorganisms, mutans streptococci are most closely associated with the development of dental caries

disease. The use of some antimicrobials and the addition of fluoride to several dietetic supplements have

resulted in the diminution of the prevalence of dental caries. Also, Restorative materials with long lasting

antibacterial surface properties may reduce the biofilm and thus disease recurrence. The antibiotics and

chemical bactericides often disturb the bacterial flora of the oral cavity and the development of multidrug-

resistant strains of bacteria is also possible; also, in some cases the use of fluoride is not very effective. For this

reason, there is a need in the use of an agent who does not generate resistance and presents a good bactericidal

property. Although the nano scale is small in size, its potential is vast. Recent advances by scientists and

engineers in manipulating matter at this small magnitude indicate potential contributions for applications

of this Nano science. The continual development of this technology will improve the ability of scientists,

manufacturers, and clinicians to create a more ideal advanced restorative biomaterial. It is not surprising that

the development of novel technologies provides the foundations for creation and application of newer and

more advanced ones. Expansion of novel technologies, particularly those involved in enriching methods of

research, have already changed the way we view and define the standards of high-quality dental materials,

tools and practices. Nanoparticles are defined as particulate dispersions or solid particles with a size in the

range of 10-1000nm. Depending upon the method of preparation, Nanoparticles, nanospheres, nanorods,

nanotubes, nanofibers, dendrimers and other nanostructures for various applications to biologic tissues and

systems can be obtained. Nanosilver as a new generation of Nano product that have a great bactericidal effect

on a several range of microorganisms, and the bactericidal effect of nanoparticles depends on the size and

the shape of the particle. The key to its broad-acting and potent anti-bacterial activity is the multifaceted

mechanism by which nanosilver acts on microbes, thus, silver ions, as an antibacterial component, have been

used in the formulation of dental resin composites. The silver nanoparticles release silver ions in the bacterial

cells, which enhance their bactericidal activity. Silver nanoparticles were studies as a pretreatment of enamel

and dentin before resin composite packing, added to the adhesive system and to resin composite restorative

itself.

90



Management of Dental Trauma in the Pediatric Patients

Abu-Hussein Muhamad

Private Dentist, Greece

Dental trauma is part of the General and Pediatric Dentistry practice. Current research has led to a

better understanding of the healing mechanisms that translate into better clinical protocols for the

management of trauma. The course will start with an introduction to trauma and the evaluation of

the patient with trauma. Then, a review of the classification, diagnosis and treatment of traumatic lesions is

presented. Finally, several clinical cases will be presented and discussed. A review of the current guidelines

(from the American Academy of Endodontic, the International Association of Dental Traumatology and the

American Academy of Pediatric Dentistry) for the management of dental trauma in the primary and permanent

dentition will be presented. Easy-to-use decision analysis and protocols for the emergency treatment as well as

follow-up and referral needs will also be discussed. Objectives present a systematic way of gathering trauma

history. Review the classification of traumatic dental injuries. Discuss the diagnosis, emergency treatment and

follow-up in primary tooth trauma according to type of injury. Discuss the diagnosis, emergency treatment

and follow-up in permanent tooth trauma according to type of injury. Present clinical cases of primary and

permanent tooth trauma.

91



What are the critical considerations to maintain optimal

oral health in the compromised geriatric patient?

Nadia Gargouri

Laval University, Canada

The state of oral health of dependent seniors, coping with a loss of autonomy, is problematic. With aging,

people consume more drugs. Some of these medications cause the dryness of the mouth (xerostomia).

Less saliva in the mouth, poor oral hygiene and frequent consumption of sweet food bring about the

development of teeth decays, periodontal disease and oral infections. In addition, loss of cognitive and physical

autonomy contributes to the rapid deterioration of oral health as seniors become unable to implement their

own dental hygiene care.

On the other hand, the accumulation of bacteria in the dental plaque and their possible spread in the

bloodstream may be the cause of cardiovascular disease, bacteremia and bacterial endocarditis. It is also

demonstrated that uncontrolled diabetes has an aggravating effect on periodontal diseases and that an

untreated periodontal disease may contribute to complicate diabetes. Moreover, oral cancer has a high

prevalence in the elderly population; especially those who have overly consume alcohol and / or tobacco. In

addition, suboptimal chewing conditions such as several missing teeth or ill-fitting dentures can affect the

choice and the quality of food and thus lead to malnutrition, loss of muscle mass and a weakened immune

system; making the senior exposed to a higher risk of infections, falls, fractures and thus morbidity and

mortality. It is therefore essential to include oral health care in a perspective of overall better health among

seniors. Finally, poor oral health has important repercussions on the quality of daily life of the elderly: bad

breath, loss of taste sense, mucosal injuries, pain, decreased self-esteem, social alienation... Improving oral

hygiene and thus health of the elderly, coping with a loss of autonomy, is therefore a major public health issue.

Sharing the same goals of improving the quality of life of the elderly, for about 10 years now, the CESBV has

been committed to the seniors by developing programs and tools dedicated to oral health prevention and

oral care needs’ detection. On the other hand, one of the CESBV mandates is to support research and that is

how, in part, several research projects in this specific area have been undertaken. The CESBV promotes its

proposals for measures and actions in favor of senior people, especially those coping with a loss of autonomy.

Also, the CESBV disseminates recommendations for the oral health of elderly dependents, emphasizing that

prevention in everyday life should be an important part of professional practice.

Biography :Nadia Gargouri, DMD, 1998, Master in Dental Sciences with specialized training in geriatric dentistry from Laval

University, 2010. Quebec Dentist since 1998, Lecturer since 2010, coordinator of the Centre of Excellence for Oral Health

and Aging at the Faculty of Dental Medicine since 2012 and research professional at the Ministry of Health and Social

Services (Screening and Dental Health department) since 2014. Quebec

92



Adhesive techniques in the management of traumatized

teeth: towards a reasoned choice

Nour El Houda Zorgui

Dental Faculty of Monastir, Tunisia

Oral trauma constitutes 15% to 50% of all craniofacial trauma. In more than nine cases of ten, an

oral trauma involves one or several tooth. This important frequency of the dental traumas infers the

necessity of mastering well their management. In reality, treatment of traumatized teeth in the dental

office is not an everyday routine act and forms an important challenge to the dentist, who have to make a crucial

decision in a short delay that will strongly influence tooth prognosis. Previously, corono-radicular fractures

implied the extraction of the tooth whereas the coronary fractures and the dental dislocations were handled

by prosthodontic procedures. Today, the spectacular progress of the adhesive materials has radically modified

the perspectives of the traumatized teeth treatment. Indeed, from the simple coronary crack passing by the

various types of tooth fractures (coronary and radicular) up to the dental dislocations (partial or total), the

adhesive techniques find all their indications. This work aims to outline the various therapeutic indications in

front of every clinical situation as well as to establish a reasoned strategy of choice of the appropriate material

allowing the practitioner to pull all the quintessence of the chosen adhesive technique and to optimize the

clinical forecasts.

Biography :Nour EL Houda Zorgui is a conservative dentistry and endodontics specialist, graduated from the Dental Faculty of

Monastir, Tunisia in June 2015. She was a resident in the dental faculty Clinic during 2011-2012 then in the dental

department of Sahloul university hospital during 2013-2015. She is an active member of Tunisian Dental Association of

Research and Study in Surgery and Pain since 2010 and of the Tunisian Society of Restorative Dentistry and Endodontics

since 2011. She is one of the founders and an active member of IADR-Tunisian section since 2012. She is a member of the

Tunisian Oral Health and Oral Rehabilitation Research Laboratory since 2013 and a Public Speaker in many national and

international Dental Events. Currently, she is a licensed private practitioner in Riyadh, Saudi Arabia.

93



Diagnosis, Prevention And Treatment Of Inflammatory

Peri-Implant Disease

Paul Fletcher

American Academy of Periodontology, USA

As the number of implants that have been placed worldwide increases and as the number of years

implants have been in place increases, the incidence and prevalence of inflammatory peri-implant

disease has been rising. Whether you are placing or restoring implants, it’s imperative you have

an understanding of the factors involved in the initiation of peri-implant disease, are able to diagnose the

problem in its incipiency and can then take the proper steps to arrest its progression.

Biography :Dr. Paul Fletcher is a periodontist who practices in New York City and is a member of Specialized Dentistry of New York,

a group implant, cosmetic specialty practice. He is an Associate Clinical Professor at the Columbia University College of

Dental Medicine where he teaches periodontics and implant dentistry on a post-graduate level. Dr. Fletcher has had more

than 30 papers published in the dental literature and has lectured extensively on periodontal prosthetics and implant

dentistry both nationally and internationally.

94



Mastering Decision Making in Periodontal Disease- ‘Pink

versus White’

Preetinder Singh

Private Dentist, India

Are you diagnosing the periodontal disease process?, have you trained your team with great verbal

skills in taking a case history?. Do you have an established periodontal protocol that everyone is held

accountable for?. Do your office team members routinely use the intraoral camera for periodontal

education? Do you have an excellent model – an unforgettable visual aid that will be seared into the patient’s

mind? Do you have the tools/instrumentation available that are needed to provide definitive periodontal care?

Is your practice current with full mouth X-rays? Is your periodontist approachable and capable of all available

periodontal treatment regimens?

95



Management of Deep caries

Qasem Alomari


Management of dental caries accounts for a great percentage of time spent in general dental practice.

Management of teeth with deep carious lesions that might involve pulpal exposure in case of

complete caries removal is a debatable issue among clinicians. The purpose of this presentation to

shed light on the options (conventional root canal treatment, direct pulp capping, indirect pulp capping, step-

wise caries removal, and partial caries removal ) the dentist have in managing such carious teeth and what is

the evidence behind each option. Clinical cases on each option will be presented.

96



Natural Crown repositioning Technique for Designing

Smiles In One day smilecorrection treatmen

Rajesh Gadekar

IDA Achalpur, India

Lots have been spoken, written and presented all over the world about designing smiles through

efficient use of veneers & crowns using allceramic and zirconia material. The technology has been

reached towards ideal perfectness & biocompatibility through evolution of e\varieties of biocompatible

materials, solutions, & high-tech digital tools & machines. But the cost of the treatment is on the higher side

day by day with each evolution and research. Concentrating focus on needs of rural India, Asia and word

wide low and medium class populations, seeking Aesthetic smile using economical & affordable alternatives

is becoming a second most centre of research in Aesthetic dentistry. Smiles can be designed instantly with the

use of direct composite veneers in low cost but still have many limitations& the indirect methods involving

laboratory makes the treatment alternatives expensive for patients as well as for aesthetic dentists. A novel

technique has been evolved ,with hundreds of adult females & male patients , from rural and tribal part of

India having severely proclinated & mal aligned anterior teeth ,providing instant smile designing with 100%

biocompatible material that is a natural enamel first time by Dr. Rajesh Gadekar & presented as a keynote

lecture in 6th Maharashtra State Zonal Dental Conference, India on 5th September 2015.The Technique is

named as Natural Crown repositioning Technique NCRT for one day smile design. The technique is being

used in rural economically under privileged adult girls of marrying age seeking instant change in smile for

marriage settlement. Here the focus is on providing them new smile in shortest possible time ,in affordable

options ,making their smiles and face beautiful to boost their self esteem and let them get selected for the

marriage ,,thus avoiding the Tragedy Of Marriage and Scenario. The social aspect of cosmetic dentistry in

Rural society of India.( First time presented in International Federation of Aesthetic Dentistry Conference in

Kyoto Japan in 1997 by Dr. Rajesh Gadekar ) The NCRT technique is based upon procuring precious natural

enamel shell from natural mal aligned tooth & repositioning it in ideal smile line using custom angulated

fibre posts ,with dual cure resin core build up materials, and bonded with 6/7 generation bonding solutions to

the canals of the teeth ,full anterior segment in one visit…Getting natural enamel veneer or crown ,efficiently

repositioned as per the Aesthetic Smile line and if needed contoured and bonded with composites as per the

detail requirements..of IDEAL SMILE LINE. The biocompatibility ,,shade matching ,,affordability ,,durability

of this AUTO GRAFTED ,natural enamel veneer is out of question,, though more chair side clinical time and

utmost skill of the aesthetic dentist is needed to achieve the great smile in one visit.presenting miraculous

results for the patients & parents, Also the NCRT treatment option makes available precious enamel,,&

further keeps open the alternatives of ceramic veneer bonding on enamel if demanded in future..

97



State of The Art of Tmj Arthroscopy

Reem H. Hossameldin


Various modalities in temporomandibular joint (TMJ) arthroscopic surgery have shown high success

rates in regards to their indications. Still further advanced modalities are required to polish and upgrade

such a valuable; minimally invasive diagnostic and therapeutic treatment option in the management

of internal derangements and degenerative joint diseases. Such advancements are met in different elements

of treatment starting with preoperative testing modalities in order to reach proper treatment planning and

education of TMD treatment cascade, walking through new medications, devices and modifications used in

different surgical procedures. Quoting Lanny Johnson; the pioneer famous orthopedic arthroscopic surgeon

saying “Show me the hole and I’d put the ball in”, we clearly demonstrate the ability to negotiate the joint

arthroscopically with all types of advanced modalities, yet the future dictates the use of growing revolutionary

tissue engineering technology in order to obviate the need to end up with open surgery and/or total joint

replacement. We are now prepared to deliver regenerative products in TMJ at any site arthroscopically. All

such advanced modalities are meant to end up with one purpose, which is reaching a brighter future meeting

the ultimate goal of treating all TMD patients through the treatment cascade primarily arthroscopically.

98



Optimizing a scientific method of utilizing Miswak in

cleaning oral cavity (methodological study)

Reham A. Albabtain

Karolinska Institutet, Sweden

Miswak, a chewing stick obtained from Salvadora persica (Arak tree) roots and commonly used in

many regions around the world as an oral hygiene tool. The aim of this study is to determine how

much of the Benzyle isothiocyanate (BITC) inside the stick is released into the mouth and how long

it is retained in saliva. Furthermore, we wanted to know if the released amounts of BITC could be antibacterial

or cell toxic.

After brushing with fresh Miswak one-to-four times by 12 volunteers with sound oral health, the amount of

BITC was quantified in the collected saliva and the used brushes using Headspace solid-phase microextraction

(SPME) and Gas chromatography–mass spectrometry (GC-MS). Antibacterial effect of the detected amount

was tested against H. influenza (Hi), A. actinomycetemcomitans (A.a), & P. gingivalis (P.g). Cytotoxicity effect

was investigated under different dosages and time intervals on gingival fibroblasts using MTT assay. Highest

amount of BITC was found in saliva and Miswak brushes after one time use and decreased gradually in brush

and drastically in saliva samples collected after two and four uses. Miswak extract and BITC compounds

showed significant inhibition on Hi and A.a using the average doses found in Saliva (23.4 μg/ml), while on Pg

it showed significant inhibition using five times dose more than that. The MTT assay showed that there was

significantly lower number of viable gingival fibroblasts when treated with 10μg/ml of Miswak oil and above

(10 and 30 min) than the control group. The results showed low content of BITC after 2 and 4 uses, and the

antibacterial effect is more effective if a fresh tip is used each brushing session. Miswak oil seems to be toxic to

gingival fibroblasts, however, Clorohexidine has the same effect using the clinical dose (0.2%).

Biography :Reham A. Albabtain is a PhD candidate in Oral Medicine and periodontal Department at Karolinska Institutet, Sweden,

since 2012. Prior to coming to Sweden, Reham worked as a dentist and a demonstrator in the department of dental

hygienist, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia, who are sponsoring her post graduate studies.

She received her bachelor degree in Dentistry from King Saud University in May 2001.

99



The mechanism of Drug-induced Gingival Overgrowth

and insight towards therapy.

Ronald S. Brown

Howard University College of Dentistry, USA

Background: Drug-induced gingival overgrowth (DIGO) is a disfiguring side effect of anti-convulsants,

calcineurin inhibitors, and calcium channel blocking agents.

Discussion: A unifying hypothesis has been constructed which begins with cation flux inhibition

induced by all three of these drug categories. Decreased cation influx of folic acid active transport within the

fibroblasts leads to decreased cellular folate uptake, which in turn leads to changes in matrix metalloproteinases

metabolism and the failure to activate collagenase. Decreased availability of activated collagenase results in

decreased degradation of accumulated connective tissue which presents as DIGO. Studies supporting this

hypothesis and potential therapeutic approaches are discussed.

Conclusion: The pathogenesis has been partially worked out and the next step is the development of a viable

therapy. Previous research supports topical folate as a viable therapeutic.

Biography :Dr. Brown is currently a professor in the department of Comprehensive Dentistry, Division of Oral Diagnosis, at Howard

University College of Dentistry. Ron Brown attended the University of Maryland and graduated from Georgetown

University School of Dentistry in 1971. He served in the US Army Dental Corps at Ft. Huachuca, AZ, and returned to

the Washington, DC Metro area in private practice in Northern Virginia and DC. He completed postdoctoral education

in pharmacology and oral medicine at Georgetown University with an MS in 1988. Since then, he has had faculty

positions at Georgetown University School of Dentistry, and the University of Texas Health Science Center at Houston

and presently as a professor of oral diagnosis at Howard University College of Dentistry (HUCD), as clinical associate

professor of Otolaryngology at Georgetown University Medical Center, and as a volunteer clinical research associate

at NHLBI/NIH, Hematology Branch. He is presently the director of continuing dental education at HUCD. His areas

of research concern oral medicine, drug-induced gingival overgrowth, clinical trials, and oral inflammatory diseases

(Chronic Oral graft versus host disease). He is a reviewer for JADA, General Dentistry, Oral Diseases, Journal of Dental

Education, Postgraduate Medicine, and Oral Surgery Oral Medicine Oral Pathology Oral Radiology, the Journal of Dental

Education, and on the editorial board of Dentistry Today, and Clinical, Cosmetic, & Investigational Dentistry. He has

over 100 published peer-reviewed journal articles, and over a dozen combined published books and book chapters and

has lectured and presented widely, both nationally and internationally. His mentors include Dr. William K. Bottomley,

Dr. William T. Beaver, Dr. Sol Silverman Jr., and Dr. Samuel Dreizen. For the last several years, he has been continuously

listed as one of the top 100 CDE providers by Dentistry Today. He is a Diplomate of the American Board of Oral Medicine

(ABOM), presently President of the ABOM, Secretary of the American Board of Dental Specialties, and a past-president

of the American Academy of Oral Medicine.

100



Dentofacial Characteristics of Oral Breathers With

Different Ages: “A Retrospective Case-Control Study”

Rosa Carrieri Rossi

São Paulo federal University , São Paulo Brasil

The influence of the breathing mode on the morphology of the dentoskeletal complex has not yet been

fully demonstrated. The aim of This an observational retrospective case-control study was to investigate

the variables associated with craniofacial developmental features in oral (OB) and nasal breathing

(NB) of 1596 patients. Nasal breathing individuals formed the control group and oral breathing study group.

Radiographic, clinical data and models were analyzed. Patients were divided into three age groups: 5-12; 13-

18; and 19-57 years old. Qualitative data were performed with the chi-square test to identify the associations

between the variables examined. Odds ratio tests were performed on the variables, when the results of the x2

tests indicated an association with the “breathing mode” variable with a reliability of 95% and a significance

of p < 0.05. The results showed that Class II malocclusion was associated with OB in all age groups. Small jaw

and increased lower anterior facial height (LAFH) were associated with OB in patients 5 to 18-years of age,

and retruded mandible was associated with OB only in younger patients, the 5-12 year old age group.The

conclusion was that dental and skeletal factors, such as Class II malocclusion, small and retruded mandible

and increased LAFH supports an association with oral breathing.

Biography :Rosa is orthodontics professor at Association Educartiva of Brazil since 30 and has completed her PhD in Federal

University of Sao Paulo- UNIFESP Brasil of Division of Pediatric Otolaryngology. Her research is oral breathing and

respiratory sleep disorders.

101



Implant Aesthetics - From Art to Digital Revolution

André P. Saadoun

Visiting Pr USC, France

The creation of an aesthetic smile with a gingival architecture in harmony with the adjacent dentition

remains the final objective in dentistry. The challenge in Perio-Implantology is to manage the hard/

soft tissue complex and to be as close as possible to the natural smile appearance of the patient in

the aesthetic zone. The process of soft and hard tissue healing must be understood and incorporated into a

carefully coordinated sequence of therapy. The soft tissue aspect following implant treatment in the anterior

zone called the “Pink Esthetic” is the most sensitive point and the one that presents the most challenges.

Therefore the preservation or the reconstruction of a natural esthetic gingival presents a major task in

Implantology. The essential prerequisites in order to establish an optimal harmonious aesthetic result should

always remain a precise, comprehensive biological and prosthetic diagnosis as well as the choice of the most

conservative, appropriate, and least traumatic treatment for the patient and achieve a successful aesthetic

outcome, always based on scientific evidence. A major evolution in Perio-Implantology has taken place with

less invasive surgery, more sophisticated approaches. The utilization of new bio-engineering materials, new

strategies using Digital Flow, has modify the surgical approaches. The final aesthetic predictability to obtain

an optimal PES and WES, in all clinical gingival and implant procedures involves a delicate surgical approach

and precise restorative dexterity to achieve an optimal aesthetic for Tooth or Implant restoration surrounded

by its natural gingival environment in harmony with the adjacent teeth.

Biography :Dr .SAADOUN has received his Degree in Dental Surgery from the Faculty of Paris and completed his Post-Graduate Certificate in Periodontology at the University of Pennsylvania and Post-Graduate Certificate in Implantology at University of California in Los Angeles.

He was an Associate Professor in the Department of Periodontics at the University of Southern California. He is also Visiting Professor at the Hadassah, Faculty of Dental Medicine of Jerusalem University.

He is a Diplomate of the American Academy of Periodonology, a Diplomate of the International Congress of Oral Implantology with a special Award of 25 years contribution for The American Board of Periodontology, a Member of Honor of the American Dental Implant.

He has received the French Medal of “Chevalier de l’Ordre National du Merite”

An internationally renowned lecturer in Esthetic Periodontology and Implantology, Dr SAADOUN has written over 150 articles and several book chapters.He was recently a contributing author in the books entitled: The Art of the Smile, The Art of Treatment Planning and recently Ridge Preservation—Updates and Innovations.He was also Associate Editor of Implant Site Development published in May 2012. His book on Soft Tissue Management on Teeth and Implants has been published in December 2012 and translated in Russian in August 2013 in Italian in July 2014and in Chinese in August 2015

A translation of the Book in Turkish, Cantonese Chinese and Brazilian will be published in 2016

He is also on the Editorial Board of scientific journals including Practical Procedures and Aesthetic Dentistry, Implant Dentistry, Dental Implantology Update, Journal of Periodontology, European Journal of Esthetic Dentistry, Cosmetic Dentistry, European Journal of General Dentistry, Journal de Paro -Implntologie Orale. In addition, Dr. SAADOUN is a Faculty member of the Global Institute of Dental Education (Los Angeles) and a Faculty member of the Dental XP Program of Education (Atlanta).Dr. SAADOUN maintains a private practice in Paris, which is limited to Esthetic Periodontics and Implant Surgery.

102



Risk factors of head and neck carcinoma; a review

Isfahan University

Isfahan University, Iran

Head and neck cancer (HNC) is the tenth most common cancer and the seventh most common cause

of cancer death in the most regions of the word. Squamous cell carcinomas (SCCS) are the most

common malignant lesion (90%) of HNC. Because, oral cancer is the most common HNC, it is a

significant health problem in the world mainly in developing countries. Despite the improvement in the

diagnosis and treatment, this lesion is still poor prognosis and with major morbidity and mortality. Therefore,

identification of risk factors is very important for prevention and early detection of cancer developing.

Methods In this review, articles were identified by researches on PubMed and Googlescholar from 2000

through 2015 in the English language. We used the following search terms: «risk factors», «oral SCC », «head

and neck carcinoma ». Case reports were excluded from this study.Results recently, many researchers have

been performed to study, a review of risk factors related to development and progression of SCC in head and

neck which have been identified already.

Conclusions it is possible to conclude that head and neck cancer development is a complex. There are many

risk factors in this field. More research is needed for better understanding of mechanisms about HNC. Identify

the important risk factors can help to the prevention and early detection.

103



Periodontitis & Peri – Implantitis – Identical or

Different?

Sagar J. Abichandani

The Dental Hub, India

Peri-implant diseases (peri-implantitis and peri-implant mucositis) are bacterially driven infections. Peri-

implantitis leads to aggressive bone resorption and eventual loss of the implant. Traditionally, peri-

implantitis was regarded as microbially similar to periodontitis, and translocation of periodontal

pathogens into the peri-implant crevice was considered as a critical factor in disease causation. However,

evidence is emerging to suggest that the peri-implant and periodontal ecosystems differ in many important

ways. The purpose of this review is to examine the evidence supporting microbial congruence and discordance

in these two communities. Current evidence suggests that osseointegrated implants truly create unique

microenvironments that force microbial adaptation and selection. Further studies that revisit the ‘microbial

reservoir’ hypothesis and identify species that play an etiologic role in peri-implant disease and examine their

transmission from teeth are needed.

104



Appraisal of the All on Four Technique – What we know,

and what we don’t!

Sameh El-Ebrashi

Private Practice, USA

The advent of immediate implant placement, and temporization using the “All on Four” technique

allows shorter treatment times using fewer implants in the treatment of partially dentate and edentulous

patients. While this technique is gaining in popularity, there are significant surgical, prosthetic, and

technical challenges. Using a multidisciplinary TEAM approach limits some of the surgical and prosthetic

difficulties that maybe encountered. The aims of this presentation are to use an evidence-based approach to

discuss the advantages, limitations, and complications associated with the protocol.

Biography :Sameh El-Ebrashi, BDS, MS, FACP obtained his dental degree from the University of Newcastle – Upon Tyne, United

Kingdom. He then completed a Prosthodontic residency at the University of Michigan, and received a Master of Science.

Dr. El-Ebrashi is a board certified Diplomate, and a Fellow of the American College of Prosthodontics. Dr. El-Ebrashi has

lectured nationally and internationally. Dr El-Ebrashi maintains a private practice limited to implants and prosthodontics

in Portland, OR.

105



An insight into Interceptive Orthodontics in the State of

Kuwait

Saud Al Anezi


In clinical orthodontic practice, there are situations where identifying the problem early would help to

facilitate the treatment and ensures better outcomes. For instance, in case of impacted maxillary canines,

treatment at a young age, could lead to better results and shorter treatment duration. The General Dental

Practitioners need to be trained to systematically screen their patients for any potential orthodontic problem

and refer them at the appropriate time. In this presentation, the concept of the interceptive orthodontics will

be discussed. Furthermore, several clinical scenarios and cases will be shown.They include: treating crowding

in the mixed dentition, space regainers, balancing/compensation extraction, treatment of supernumerary

teeth, impacted maxillary/mandibular canines, the use of Functional appliances, treating developing Class 3

malocclusion, the use of RPE and treatment of hypodontia in adolescents.

Biography :Dr. Saud A. Al-Anezi obtained his BDS Degree from the University of Liverpool, UK in 2001. He then returned to Kuwait

to work as an assistant registrar. In 2004, He got his MFD from the RCS in Ireland. He then joined an Orthodontic

Residency Program in the University of Bristol, UK. In 2008, he obtained his Doctorate in Orthodontics from Bristol

University. Later that year, he got his MOrth from the RCS of Edinburg, UK. In May 2011, Dr. Al-Anezi published a report

in the American Journal of Orthodontics and Dentofacial Orthopedics journal (AJO-DO) and it was chosen as Case of the

Month and is available online on the Association’s website. Dr. Al-Anezi is an active member of the American Association

of Orthodontists and the World Federation of Orthodontics. He currently works as a Senior Specialist Orthodontist in

the Ministry of Health and in a Private Clinic in Kuwait City, Kuwait. Dr. Al-Anezi is also a seconded Clinical Tutor at

the Faculty of Dentistry, Kuwait University and is a Lecturer in the Dental Residency Program of the Kuwait Institute for

Medical Specialization, Ministry of Health, Kuwait.

106



Myofunctional Aspects In Orthodontics

Simma Irmgard

Ã–GZMK - Gesellschaft ganzheitliche Zahnheilkunde, Austria

This study was intended to evaluate the Myofunctional-disorders (stress parameters) of muscle palpation

in children and adults before orthodontic treatment. Based on the studies done in adult patients with

TMJ and craniomandibular-disorder we also found a high sensitivity of tension in particular muscles

of the stomatognathic system in children and adults before orthodontic treatment. Material and methodsIn

187 patients – 138 were children between the ages of 7-17 years old, 49 were adults between 18-58 years of age,

81 male and 106 female – with different orthodontic diagnosis (Class I, II, II, etc). Manual muscle palpation

was performed in 9 muscles. Sensitivity, pain, and tension were evaluated in scores from 0 to 3, with each

the left and right side done separately and in sum.Results The highest score sensitivity (187 patients - max

1122 scores) was found in sum withthe following muscles: m. pteryg. lat (698), m. pteryg. med (568), atl. occ.

(452), m.sternocleid. (304), m. biventer (250), suprahyoidale m. (191), infrahyoidale m. (178),cran. mand.

(112), m. masseter (99).ConclusionThe statistical outcome and comparison between the children group and

the adultgroup show a higher score intensity in adults. So Myofunctional-disorders (Tonguetrust etc.) seems

to be better managed with the earlier introduction of orthodontic treatment.In Angle Class 1 patients scores

are lower and Angle Class 2 & 3 scores of dysfunctional muscles are higher. We conclude that this specific

malocclusions have specific patterns of dysfunctional muscles.

107



Complications in Sinus Lifting

Sirous Risbaf Fakour

AO Foundation, Iran

A key implant success is the qual;ity of the bone where the implant is to be placed. The upper back aw

has traditionally been one of the most difficult areas to successfully place dental implants due to in

sufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that

area due to reasons such as periodontal disease or tooth loss, you may be left with out enough bone to place

implants.Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for

the placement of dental implants. Several techniques can be used to raise the sinus and allow for new done

forming. In one common technique, an incision is made to expose the bone.Before treatment all patients

were clinically and radiography examined by panoramic radiography and computed tomography scanning

in selected cases. Available bone volume, bone quality and anatomy and any existing sinus pathology. The

most common surgical complication is the perforation of the schneiderian membrane it occurs in 7% to 10%

to 35% of sinus floor elevation procedure. Membrane perforation, according to the literature are strongly

associated with the appearance of postoperative complication and consists mostly of acute or chronic sinus

infection bacterial invasion, swelling and bleeding wound dehiscence, loss of graft material and disruption of

normal sinus physiological function. Perforated management of membrane perforation is not clearly defined

in the literature various surgical techniques to overcome this perforating include suturing, and use of a fibrin

adhesive. Small perforations usually do not need treatment because the membrane folds on itself during

elevation. However large perforations are usually manage using bioabsorbable membrane

Biography :Dr. Sirous Risbaf currently working as oral maxillofacial surgeon at AO Foundation previous he had worked at Khatem

Hospital, his education was completed at dental school.

108



Er:YAG laser irradiation combined with APF treatment

of the primary tooth enamel

Subash Singh

Babu Banarasi Das College of Dental Sciences, India

Background: Laser irradiation and fluoride has been used as a preventive measure to combat dental

caries both in permanent and primary teeth but little has been done to compare their effect among

both the dentition. Aim: The aim of this study was to evaluate the effect of Er:YAG laser application

with and without fluoride on the acid resistance of primary and permanent tooth enamel. Study Design: An

in-vitro randomized-controlled trial was carried out in 80 enamel blocks of sound teeth and were allocated to

four groups of 20 teeth (10 primary and 10 permanent teeth) each – Group 1 (No treatment), Group 2 (Laser

only), Group 3 (Fluoride only) and Group 4 (Laser + Fluoride). Thereafter, pH cycling was done for 9 days

and the enamel blocks were sectioned. The samples were subjected to assessment of surface microhardness in

terms of Vickers Hardness and surface morphological changes were observed using SEM. Data obtained was

analyzed using ANOVA. Results: SEM for primary teeth showed higher proportion of melting without any

crater formation and surface irregularities thereby significant increase in microhardness with the maximum

VHN of 372.40 while permanent teeth showed marked demineralization with crater and crack formation

and reduced microhardness with the minimum VHN of 187 .Conclusion: Er:YAG laser irradiation combined

with APF treatment of the primary tooth enamel gave morphologically hardened enamel surface than the

permanent teeth which can be a protective barrier against a cariogenic attack.

109



Photodynamic Based Technology For Modern Oral

Diagnostic And Therapeutic

Vanderlei S. Bagnato

Instituto de Física de São Carlos , Brazil

In this presentation we shall describe a collection of work done by our research group, involving the

development and implementation of techniques based on biophotonics to improve the oral health of

patients. We shall present clinical studies as well as the development of instrumentation which made

available in the market such technologies. Starting with the diagnostic, using a combination of optical

fluorescence and far field images, we can detect from dental decay to cancer on the soft tissue. Observation

of the mucosa modification and its relation with cancer , allow a multivariable analyses , producing high

sensitivity and sensibility. Lesions can be detected before they appear . In special we have also concentrated

on the visualization of bacterial plaques and localized infection as well. Out of our research, a device named

EVINCE is today launched in the market. As for the treatment, we are focusing on cancer and infections. Many

procedures and devices based this principle has been developed for the treatment of mucosite, periodontal

diseases, overall mouth decontamination and most recently the decontamination of dental prosthesis. Recently

decontamination of oral-faring infections has produced incredible results. As for the cancer, many cases of

SCC on the mucosa, mouth floor and tongue has been applied with a great success. In this presentation we

will cover those new and exciting techniques and discuss the future of oral diagnostic and treatment on the

basis of those new technologies. Special attention shall be given to the new increasing incidence of oral HIV

( work supported by FAPES, FINEP and CNPQ). A full list of papers and books can be found at http://cepof.

ifsc.usp.br , on the area of biophotonics.

Biography :Vanderlei Salvador Bagnato, born in 1958, , is PhD from MIT (1987). Double major in Material Science Engineering

(Universidade Federal de São Carlos - Brasil - 1981) and Physics (Universidade de São Paulo - Brasil - 1981). Received

the title of “Livre – Docente”t by University of São Paulo (1989) and Full Professor by University of São Paulo (1993). Has

his activities based on laser cooling and trapping of neutral atoms and applications of optics and laser to health science.

Among many activities, he pursued a pioneering work in the field of atomic and molecular physics with worldwide

recognition. Quantum Turbulence involving atomic superfluid, and time and frequency metrology with the construction

and evaluation of the first atomic clock developed in Latin America and the first pilot plant for the production of high

precision microscopes. Recently the group of research under his guidance has implemented in Brazil by the first time the

clinical use of Photo-Dynamic-Therapy for the treatment of cancer and microbiological control. A strong relation between

basic research and industry is one of the characteristics of the work carried on by Bagnato, resulting the implementation of

high technology industries in the field of optics. Has published over 500 papers in international journals with more than

9000 citations. Has written 8 books in application of opticas for health care. During his academic life, he has supervised

more than 75 graduate students and he is presently supervising 21 graduate students involved in several programs of

research as well as many undergraduates. Is a member of United State Academy of Science, Vatican Academy of Science,

Brazilian Academy of Science and TWAS Academy of Science.

110



Immediate loading of short Straumann® TE implants

with a chemically modified surface (SLActive)

Vladimir Kokovic

Advanced European Medical Centre, United Arab Emirates

Objectives: The aim of this study was to compare clinical results of immediate and early loaded self-

tapping implants with a chemically modified surface placed in the posterior mandible.

Material and methods: Fifteen patients with bilateral edentulous posterior mandibles were randomly

selected to be treated with either immediately (IL) or early loaded implants (EL). Ninety short, self-tapping

implants with SLActive surface (Ø 4.1/4.8mm; 8mm length) were analyzed in this study. Implants from IL

group (45) were loaded on the day of surgery and from EL group, 3 weeks following surgery. The measurement

of the implant stability quotient (ISQ) was performed on the day of implant placement as well as 1, 2, 3, 4, 5,

6, 12 and 52 weeks after. Bone resorption, was recorded at 1, 5 and 7 years following implant loading.

Results: After 7 years, implant survival in both groups was 100%. The mean value of primary implant stability

was 80.80 ± 0.49 ISQ. A statistically significant decrease in implant stability was observed in both groups

during the first week of loading. A significant longitudinal increase in ISQ value was displayed in the IL and

EL groups during the 52-week observation period. The differences between immediately and early loaded

implants were statistically insignificant (P > 0.05). At 7 years, no statistically significant differences were

found, between immediately and early loaded implants, in the mean crestal bone loss values (0.5 ± 0.22mm

vs. 0.6 ± 0.1mm).

Conclusion: The present clinical study demonstrated that short Straumann® TE implants, with a chemically

modified surface (SLActive), provide a high value of primary implant stability adequate for the immediate

and early loading protocols in the posterior mandible. The long observational period reaffirms the successful

treatment provided by this type of implants, in both the immediate and early loading protocols.

111



Oral Potentially Malignant Lesions and Oral Cancer

Waleed Y. Zaid

LSUHSC, USA

It is our role as oral health care providers to exam the oral cavity soft and hard tissues, identify potentially

malignant lesions, work them up, diagnose them and finally treat them.

Also in this presentation we are going to identify potentially malignant lesions both clinically and

histologically, risk factors, recent advances in diagnosing these subtype of lesions utilizing different modalities

like tissue fluorescence, types of biopsies to achieve a confirmed diagnosis.

Finally, we are also going to talk about the work up of oral cancer patients, available treatment and rehabilitation

of these patients and long term surveillance of oral cancer survivor patients.

112



Role of Galvanic Current On Remineralization of Novel

Dental Cements (In vitro & In vivo)

Yasser F Ali Gomaa

Minia University, Egypt

This study was done to evaluate copper phosphate cement and a newly formulated cement containing

cupper and tin as capping materials.

Study design (in vitro and in vivo): in vitro phase: we used 25 extracted human premolars. Groups

according to capping material A-E, n=5 each; no material, varnish, Ca(OH)2, copper phosphate cement

or newly formulatedone. Remineralizations were evaluated by Vicker’s Microhardness tests. Data were

statistically analyzed by ANOVA. In vivo phase, 30 class V cavities were prepared in 10 rabbits and grouped

according to the capping material (I-III; n=10); Ca(OH)2, copper phosphate cement and the newly formulated

one. Histopathological evaluations were done.

Results: Vickers microhardness number of groups A-E were 63.6, 52.3, 53.7, 58.9 and 59.4. Significant

differences were observed between all groups except group C.

For the in vivo phase: Group I and II showed dentine bridge formation.

Conclusion: Both copper phosphate cement and newly formulated cement have promising pulp capping

effect.

113



Influence of Implant Position on Stress Distribution in

Implant-Assisted Distal Extension Removable Partial

Dentures: A 3D Finite Element Analysis

Yeganeh Memari

Shahid Beheshti University of Medical Science, Iran

Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-

fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage

during compression forces. It may be potentially destructive to the abutments and the surrounding

tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension

implant assisted removable partial dentures. Three-dimensional models of a bilateral distal extension partially

edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable

denture and an implant (4×10mm) were designed. With the aid of the finite element program ANSYS 8.0, the

models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von

Mises Maps were plotted for visualization of results. When an implant was placed in the second premolar

region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was

shown on implant and bone in the 1st molar area. Implants located in the first molar area showed the least

distribution of stresses in the analyzed models.

Biography :Yeganeh Memari is an Assistant Professor of Dentistry in the Removable Prosthodontist Department at the Dental School

of Shahid Beheshti University of Medical Sciences. She received her DDS degree at Tehran University, and went on to

complete her specialization in Prosthodontist at Shahid Beheshti University of Medical Sciences. Additionally, she held a

Fellowship in Prosthodontist that was completed at the University of Toronto. Dr. Memari continuously pursues different

research topics, with some of her research interests including the following: removable prosthodontist, implantology, and

geriatric dentistry.

114



Dental Considerations in Head and Neck Radiation and

Chemotherapy Cancer Patients

Zafrulla Khan

J.G.Brown Cancer Center, USA

Introduction and Discussion: Head and Neck cancer patients treated with Radiation and Chemotherapy

may encounter side effects like xerostomia, mucositis, radiation caries, osteoradionecrosis etc. Early

diagnosis, prevention and appropriate treatment will improve the quality of life for these patients.

All oral health care providers can play a role caring for head and neck cancer patients; by Pretreatment

evaluation, Early detection/prevention of oral and dental complications; Reducing the risk and severity of oral

complications and Treatment including follow up strategies.

Conclusion:This patient-oriented presentation will provide the Dental professional with information for the

management of the oral and dental needs of cancer patients, before, during and after cancer therapy. The oral

healthcare team is a valuable part of helping patients with cancer. The patient’s quality of life can be improved,

as well as the compliance with the cancer treatment supporting the patient with better oral health, the overall

long-term prognosis.

115



Non-invasive implant surgery – flapless and guide

implantology

Zoran Vlahovic

Medical Faculty Pristina, Yugoslavia

Flapless surgical technique can be defined as a minimally invasive dental implant placement procedure

without the lifting of mucoperiosteal flap. Practical application of this surgical technique in implantology

is directly linked to the introduction of new technologies into dentistry, i.e. for the introduction of

CBCT (Cone Beam Computer Tomography) devices and software which are used for implant placement

planning. The flapless surgical procedure objectively results in less trauma during the implant placement and

for its implementation we need a 3D x-ray image by the means of which we can visualise bone tissue. The

implant socket is prepared by stent guides and this placement manner is characterised by an optimum implant

placement and predictable future denture placements. Comparison between flap and flapless surgical technique

have been the subject matter of both clinical and experimental studies. The clinical studies of flapless technique

deal with the local response of peri-implant tissues: post-operative oedema, peri-implant mucosa condition,

Resonance Frequency Analysis, degree of peri-implant bone resorption, and patient survey data (anxiety,

pain, swelling, recovery). The experimental studies are based on histopathological analysis of soft and bone

peri-implant tissue, level of osseointegration, etc. In our presentation, we will show the results of a comparative

three-month experimental study of flap and flapless implant technique in which we used domestic pigs. In

the study, we performed: resonance frequency, radiographic, histopathological, immunohistochemical and

histomorphometric analyses of implants placed using flap and flapless technique. Additionally, we will present

the results of in vitro study performed on bovine ribs, where we studied temperature changes in bone tissue

while using flap and flapless implant placement technique.Furthermore, we will use clinical cases to present

manner of performance and types of flapless technique, application of computer-guided implant placement

and 3D printed dental implant surgical guides, together with their practical advantages and disadvantages.

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