The rehabilitation of the severely atrophied edentulous maxilla poses a great challenge to surgeons and prosthodontics that work on this particular area. The classic approach implies bone augmentation techniques by means of bone grafting, bone distraction techniques and others. All of these require major surgery, sometimes associated with morbidity at donor and receptor sites and functional rehabilitation of the patient must occur in two surgical stages.
Since the development of the zygomatic implants by Per-Ingvar Brånemark, there’s an alternative to bone grafting techniques, using the body of the zygomatic bone as major point of anchorage to a intraoral osteointegrated implant. This procedure allows the patient to regain orofacial function in only one surgical stage, with high predictability, less morbidity, time spend and costs.
Peri-implant diseases are defined as pathological inflammatory reactions in the tissue surrounding the osseointegrated implant. They are classified into two categories: mucositis – defined as peri-implant soft tissue inflammation and peri-implantitis – bone loss in the peri-implant region.
A clinical case of a 55 years old female with a zygomatic implant at the anatomical position of 1.6 and a follow-up of 6 years is presented. A bone defect was observed in the cervical region of the implant accompanied by mucosal dehiscence.
The proposed approach in the exposed clinical case involves the use of Implacure® Protocol, whose combination of the mechanical decontamination technique, together with the use of disinfectant chlorhexidine and orthophosphoric acid, added with the combination Piperacillin + Tazobactam together with hyaluronic acid, provide a base that allows to regenerate the bone and increase the survival time of the implant.
Keywords: Zygomatic Implant; Peri-implantitis; Implacure® Protocol.

Calcium Sulfate has been used since 1892 (Dreesman) as a graft material to regenerate bone in cases of tuberculosis, it being the most studied material for its osteoconduction and biocompatibility.
The difficulty of Calcium Sulfate’s clinical manipulation and its setting time in the maxillofacial area led Dr. Amos Yahav to create a single product made of two matrices: one formed by a mixture of calcium sulfate hemihydrate and calcium sulfate dihydrate, and the other formed by hydroxyapatite. The Calcium Sulfate matrices is activated with sodium chloride meanwhile the hydroxyapatite does not undergo any changes.
The product is called Bond Apatite® and comes in syringe to facilitate the mixing of the powder with the liquid and its clinical use on bone defects.
The advantage it has on other materials is its easy handling, primary graft stability and high porosity, favoring angiogenesis and intragranular reabsorption, leaving less than 10% graft material in the new formed bone, exclusively hydroxyapatite, the Calcium Sulfate having completely disappeared.
Keywords: Calcium Sulfate; Graft; Extraction

Background: The case report explains the rehabilitation of the maxillary first and second premolar extraction socket with immediate implants and provisionalization by bonded restorations.
Materials and Methods: The root stumps in the region of maxillary premolars were atraumatically extracted. The osteotome was prepared to the required depth and tapered threaded Dental implants were selected for initial stability and rapid osseous adaptation. Biocare Implants were placed, with graft material and collagen membrane. The healing abutment was placed following which a nonfunctional immediate restoration was delivered.
Results: The immediate implant surgery and nonfunctional loading in the region of the extraction sockets resulted in preservation of tissues i.e. both hard and soft tissues showing no significant complications. Moreover, the patient exhibited a healthy gingival architecture with no radiological complications after loading.
Conclusion: The dental Implant placement and the prosthesis or provisional restoration provided the patient with fulfilled esthetic needs, satisfactory function, efficacy of mastication and most importantly, preservation of hard and soft tissues.
Keywords: Occlusal Loading; Osseointegration; Invasive; Nonfunctional Restoration

Currently, the orofacial harmonization performed by the dentist has been growing exponentially. Several techniques contemplate this list of procedures, among them the application of botulinum toxin; facial fillers; facial lifting (polydioxanone thread); autologous blood derivatives; percutaneous collagen inducers; hormonal regulation; biophotonic procedures and therapeutic laser; facial lipoplasty; bichectomy; and liplifting. In the facial and peribucal filling technique, the main material currently used is hyaluronic acid. Naturally, hyaluronic acid is an endogenous intercellular component of our tissues. Synthetically, it is used in rehabilitation and aesthetic medicine, gaining, in this last indication, greater property. However, due to aesthetic applications, several complications have been reported, including the formation of granulation tissue (foreign body) and possible risk of tissue necrosis. In this perspective, the application of hyaluronidase has been carried out indiscriminately. However, hyaluronidase can also present possible complications. The purpose of this article is to present the possible complications resulting from the application of hyaluronidase, and to discuss the importance of rational use in Dentistry.
Keywords: Hyaluronidase; Hyaluronic Acid; Dentistry

Introduction: Lamia dura is one of the important components in the “periodontium” that encircle the socket of the tooth because it provides the connection area to the periodontal ligaments (Sharpey’s fibers). In addition, the lamina dura has a significant role in the remodeling of the bone, so in this way in orthodontic therapy. The presence of intact and regular lamina dura often refers to a “healthy periodontium”. Many conditions may affect the status of lamina dura, which may lead to disruption in the symmetry and uniformity of the lamina dura.
Purpose of the Study: To observe the possible “radiographic changes” of lamina dura in patients treated with “corticosteroids”.
Materials and Methods: The study included fifty-two individuals aged between 18 – 45 years who referred to the oral radiology units in some dental specialized centers of Baghdad capital from December 2018 to December 2019 for taking periapical radiographs. Thirty-two of individuals were healthy and without any systemic diseases and they are considered as a control group and the other twenty individuals were with a history of treatment with different doses of “oral or systemic corticosteroids” for at least two years ago and up to five years maximum and they are considered as patient group. A total of 1439 “periapical radiographs” selected in the study for evaluating the thickness of lamina dura including the anterior and posterior teeth in upper and lower jaws and excluding third molars for two groups. All “periapical images” were viewed on the monitor using digital radiography. Different patterns of examining lamina dura from the two groups had shown in “periapical radiographic images”.
Results: From the total of the two groups, the results in the patients treated with “corticosteroids” showed that the pattern IV of lamina dura was more than the other patterns in the percentage of 21.61%, followed by pattern V (13.96%), the pattern I (8.33%), pattern II (4.37%), pattern III (3.26%) respectively. In addition, the results showed that the pattern I of lamina dura was more in the control group in percentage of 35.71%, followed by pattern V (4.51%), pattern III (3.68%), pattern II (2.64%) and pattern IV (1.87%), respectively. The statistical analysis showed that there was no significant relationship regarding the lamina dura changes between the patients’ group and healthy group of p-value < 0.05 (Spearman’ Rho, rs = 0.2, p-value = 0.7).
Conclusion: The study found that the use of “corticosteroids” has no direct effect on the status of lamina dura.
Keywords: Hyaluronidase; Hyaluronic Acid; Dentistry

Aim: The present cross-sectional study was conducted to evaluate the knowledge and attitude of mother’s towards orthodontic treatment for children in Aseer region, Kingdom of Saudi Arabia.
Materials and Methods: A cross-sectional study was carried out on the sample size of 150 mothers’ attending outpatient pediatric dental clinics in Female College of Dentistry King Khalid University, Abha, Saudi Arabia. Written informed consent was obtained from the participants after explaining them the purpose of the study. Sampling method included in the study is a simple random sampling method. The questionnaire was formulated, which comprised of two parts: The first portion included the questions related to the demographic information of participants, such as age and educational qualification. The other part of the questionnaire comprised 15 questions related to knowledge and attitude of orthodontic treatment for children. The survey data was collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA), and was statistically analyzed.
Results: Eighty-nine participants (59%) think that heredity can influence the occurrence of malalignment of teeth (Table 3). A total of 84% of participants agreed that oral habits have ill effect on teeth; 62% do not decide to remove the primary tooth with pain and caries. Mothers’(55%) believe that early removal of primary teeth will affect the eruption of permanent teeth into irregular. 132(88%) of participant know that taking proper orthodontic treatment at an early age would improve their facial appearance. Majority of participants (53%) disagreed that if primary teeth exfoliate prematurely, space maintenance device could be applied to prevent secondary dentofacial deformities.
Conclusion: Awareness of malocclusion among parents needs to make correction towards their children orthodontic treatment. Orthodontists need to carry out orthodontic treatment awareness among parents by various oral health education programs and acquaint to handle the parents with a negative attitude towards orthodontic treatment.
Keywords: Knowledge; Children; Orthodontic Treatment; Mothers; Saudi Arabia