Publications by authors named "Ahmed Mamdouh"

15 Publications

  • Page 1 of 1

Alveolar Cleft Reconstruction Using Double Iliac Corticocancellous Bone Plates Grafting Technique in Mixed Dentition Phase.

Cleft Palate Craniofac J 2021 Sep 24:10556656211042160. Epub 2021 Sep 24.

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, 110152Cairo University, Cairo, Egypt.

Objective: The primary goal of maxillary alveolar cleft reconstruction in patients with cleft lip/palate at the phase of mixed dentition is to build bone in the cleft area which in turn allows closure of the oronasal fistula, establishes arch continuity, and improve maxillary stability. This study aimed to evaluate the double iliac corticocancellous bone plates grafting technique for initial alveolar cleft grafting.

Design: This prospective study was conducted on 12 consecutive patients with unilateral complete alveolar cleft and previous cleft lip and palate corrective surgery.

Intervention: For all patients, the iliac crest graft was harvested and cut into 2 cortical bone plates and adapted labially and palatally. Both plates were fixed with screws then the gap between the 2 plates was filled with cancellous bone. The grafted side was compared to the contralateral side 9 months postoperatively regarding labio-palatal alveolar width and bone density, while the 9 months postoperative graft height was compared to the immediate postoperative height using computed tomography scans.

Results: All grafted sides showed similarity to the contralateral sides regarding both alveolar width and bone density with minimal crestal bone resorption.

Conclusion: The double iliac corticocancellous bone plate grafting technique seems to be a reliable method for alveolar cleft reconstruction with adequate bone quality and contour.
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September 2021

In-vitro and in-vivo investigation of amygdalin, metformin, and combination of both against doxorubicin on hepatocellular carcinoma.

Life Sci 2021 Nov 15;285:119961. Epub 2021 Sep 15.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt; Faculty of Pharmacy, BUC, Cairo, Egypt.

Aim: Hepatocellular carcinoma (HCC) is a potentially life-threatening cancer. In the current study, anti-HCC efficacy of amygdalin, or metformin alone or in combination in comparison to doxorubicin was studied.

Main Methods: Both in-vitro and in-vivo based models. HepG-2 and Huh-7 cell lines as established in-vitro model for HCC were treated with different concentrations of indicated drugs to evaluate the cytotoxicity and determine IC for 24, 48 and 72 h. Moreover, the effect of different treatments on apoptosis and cell cycle using flow cytometric analysis were studied. Hepatocellular carcinoma induced in rats by diethyl-nitrosamine and carbon tetrachloride was established, to further investigate the efficacy of indicated drugs. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase were measured by spectrophotometer, alpha-fetoprotein, cytochrome-c, caspase-3 and malondialdehyde were measured by ELISA, and liver biopsies were also evaluated histopathologically.

Key Findings: In-vitro results showed that the combination has a promising effect when compared to amygdalin or metformin alone as it is more cytotoxic and have higher ability for induction of apoptosis and arresting cell cycle. In-vivo doxorubicin has a good effect for treating HCC. Also, the combination showed a promising prognostic effect depending on the cytotoxic activity and tumor marker when compared to amygdalin or metformin alone.

Significance: Based on the current data, it was hypothesized that amygdalin and metformin especially when used in combination will be a promising approach with low side effects for enhancement of HCC.
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November 2021

Three-Dimensional Echocardiography in Evaluating LA Volumes and Functions in Diabetic Normotensive Patients without Symptomatic Cardiovascular Disease.

Int J Vasc Med 2020 19;2020:5923702. Epub 2020 Aug 19.

Department of Cardiology, Ain Shams University, Cairo, Egypt.

Background: Cardiovascular complications are the most serious threat to diabetic patients. Associated metabolic and microvascular changes are the main cause of cardiac function affection, and the earliest cardiac change is diastolic dysfunction. Assessment of LA function changes is a key to determine early heart damage of diabetic patients.

Objectives: To evaluate the effect of diabetes mellitus on left atrial volumes and functions by using real-time 3-dimensional echocardiography in normotensive patients free from cardiovascular disease.

Methods: The study included 110 individuals, 50 controls and 60 patients with diabetes mellitus, 30 patients with type 1 diabetes mellitus and 30 patients with type 2 diabetes mellitus. 2-dimensional echocardiography was used to assess the LA maximum volume and LA phasic volumes, and LA maximum volume indexed to body surface area were measured by 3D echocardiography. LA functions (LA total stroke volume, LA active stroke volume, and LA active emptying fraction) were obtained from RT3D volumetric analysis.

Results: The results of the analysis revealed that type 2 diabetes mellitus showed enlarged , , and LAVi with an increased LA total stroke volume and decreased active emptying fraction, while type 1 diabetics showed only decreased in active emptying fraction. The LA maximum volume indexed to body surface area (LAVi) was significantly higher in type 2 diabetic patients as compared to normal controls which was 23.55 ± 3.37 ml/m versus 20.30.

Conclusion: Patients with type 2 diabetes mellitus have an increased LA volume with impaired compliance and contractility, while patients with type 1 diabetes mellitus have only impaired contractility compared to nondiabetic subjects.
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August 2020

Computer guided temporomandibular joint reconstruction of Kaban III hemifacial microsomia with anotia: A case report.

Int J Surg Case Rep 2019 16;57:52-56. Epub 2019 Mar 16.

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt. Electronic address:

INTRODUCTION, Hemifacial microsomia is the second most common craniofacial congenital anomaly. It corresponds to a group of malformations ranging from minimal facial asymmetry to sever form affecting mandible, soft tissues, orbit, ear, and cranial nerves. PRESENTATION OF CASE, We present a case of 6 years old patient with Kaban class III hemifacial microsomia with anotia. Temporomandibular joint was reconstructed by costochondral graft using computer guided surgery (simulation and rapid prototyping). A computer guided soft tissue guide, mandibular, and maxillomandibular/zygomatic models were constructed using rapid prototyping technology. The customized computer guided soft tissue guide was used to localize the proper position of skin incision, the mandibular model was used for preoperative reconstruction plate bending, and the maxillomandibular/zygomatic model was used to estimate the rib graft length and position. Postoperative assessment showed proper positioning of the graft, with no complications or facial nerve affection. DISCUSSION, In this report, we introduce a new computer guided technique to estimate and identify the proper position of the temporomandibular joint graft based on patient CT. This technique eliminated the need of extended incisions with excessive dissection and provided a more accessible field for rib graft fixation, facilitating the surgical procedures. CONCLUSION, The use of computer guided surgery (simulation and rapid prototyping) for temporomandibular joint reconstruction in Kaban III hemifacial microsomia with anotia facilitates the surgical procedure, minimizes procedure time, increases precision, and reduces possible complications.
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March 2019

Assessment of Osteoimmunological Changes Following Orthognathic Surgery.

Open Access Maced J Med Sci 2019 Feb 27;7(4):632-636. Epub 2019 Feb 27.

Clinical Pathology Department, Pharos University in Alexandria, Alexandria, Egypt.

Background: There is a scarcity in the published literature which evaluates the postoperative inflammatory response and patients' immunity following orthognathic surgery.

Aim: The present prospective study aimed to evaluate the changes in two immunological callipers to measure the traumatic effect of orthognathic surgery.

Methods: In the present prospective cohort study, we included women (age range 16-30 years) with severe dentofacial deformities who were scheduled for bimaxillary osteotomy. Blood samples were collected for measurement of transforming growth factor beta one (TGF-β1) and osteoprotegrin (OPG) levels. The statistical analysis was carried with SPSS software.

Results: In the present study, nine patients with severe dentofacial deformity were operated successfully under general anaesthesia. All patients reported decreased energy and fatigue in the early days after surgery and had difficulties with nutrition due to pain, oedema and paresthesia; however, no massive weight loss was reported. The levels of OPG started to increase immediately postoperatively (mean = 0.46 ± 0.08; p = 0.001). A significant increase in the concentration of OPG begun postoperatively and continued to rise significantly until the six weeks to reach 2.24 ± 0.30 ng/mL (p < 0.001). Similarly, the concentration of TGF-β1 increased at three days postoperatively and continued to rise until the six weeks to reach 1.28 ± 0.19 ng/mL (p <0 .001).

Conclusion: In conclusion, orthognathic surgery is associated with a significant rise in the pro-inflammatory cytokines until the six weeks postoperatively. These observed results may indicate a significant alteration in the immunity of the patients to undergoing orthognathic surgery.
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February 2019

Role of speckle tracking echocardiography in detecting early left atrial dysfunction in hypertensive patients.

Egypt Heart J 2018 Sep 19;70(3):217-223. Epub 2018 Jun 19.

Cardiology Department, Ain Shams University Hospital, Cairo, Egypt.

Background: Arterial hypertension adversely affects left atrial (LA) size and function, effect on function may precede effect on size. Many techniques were used to assess LA function but with pitfalls.

Objectives: Early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size.

Patients And Methods: The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls, all with normal LA volume index and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study with assessment of LA functions [total LA stroke volume, LA expansion index by conventional 2D echocardiography and Global peak atrial longitudinal strain by speckle tracking (PALS)], left ventricular (LV) systolic and diastolic functions, and LV mass.

Results: Different indices of LA dysfunction (Total LA stroke volume, LA expansion index and global PALS) were significantly lower in the hypertensive group despite the normal LA volume index in all the studied subjects. The presence of diabetes mellitus (DM) and higher grade of LV diastolic dysfunction were significantly associated with lower global PALS. The higher age, systolic blood pressure (BP), body mass index (BMI), LA volume index, and LV mass index and the lower LA expansion index were associated with lower global PALS.

Conclusion: Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs.
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September 2018

Frontal Sinus Obliteration Utilizing Autogenous Abdominal Fat Graft.

Open Access Maced J Med Sci 2018 Aug 21;6(8):1462-1467. Epub 2018 Jul 21.

Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

Background: Frontal sinus fractures have always been unique because of the controversy surrounding their ideal treatment protocol and the fatal complications that could follow if the wrong treatment opts.

Aim: The purpose of this study was to assess clinically and radiographically frontal sinus obliteration technique utilising autogenous abdominal fat graft.

Patients And Methods: This study was carried out on 20 patients having anterior table fracture of their frontal sinuses indicated for sinus obliteration. All sinuses were obliterated using autogenous abdominal fat graft. Post-operatively, patients were clinically evaluated for any signs or symptoms of intracranial infections, wound dehiscence, sinus affections, or aesthetic deformity. Computerized tomography (CT) radiographic evaluations were carried out immediately and 12 months postoperatively to evaluate any uneventful healing of the graft.

Results: Clinical follow-up showed no cerebrospinal fluid leak, no postoperative infection or wound dehiscence in 18 cases. There were two cases however that showed infection. Radiographic follow-up revealed uneventful healing of the abdominal fat grafts with no abnormality detected in the sinus cavity throughout the whole postoperative period.

Conclusion: Autogenous abdominal fat graft appears to be a successful obliteration material in the frontal sinus cavity and is beneficial in fractures of the anterior table.
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August 2018

Dorsal versus ventral strip augmented anastomotic bulbar urethroplasty: retrospective study.

Int Urol Nephrol 2018 Jul 9;50(7):1257-1261. Epub 2018 Jun 9.

Department of Urology, South Valley University, Qena, Egypt.

Purpose: The published literature shows controversies with regard to the treatment of choice for longer stricture. Augmented anastomotic urethroplasty (AAU) was described for long bulbar urethral strictures with an extended area of narrowing and fibrosis, the technique combines the advantages of both anastomosis and graft substitution. We aimed to compare the dorsal and ventral strip anastomosis in the AAU.

Methods: A retrospective Review was conducted at the Department of Urology, Sohag University Hospital; we included adult patients with long bulbar urethral strictures (> 2 cm) who underwent dorsal or ventral strip AAU. Patients were followed at 1, 3, 6, and 12 months postoperatively for subjective improvements. The statistical analysis was carried with SPSS software version 24 for windows.

Results: At the end of follow-up, stricture recurrence occurred in 5 (12.5%) in ventral strip group compared to 6 (23.1%) in dorsal group, the difference was not statistically significant (p = 0.5). With regard to safety outcomes, there was no statistically significant difference between both groups in any of the postoperative complications, except post-void dribbling which showed higher incidence in dorsal strip group (p < 0.001).

Conclusions: In conclusion, both dorsal strip and ventral strip techniques are feasible for long bulbar urethral strictures with comparable postoperative efficacy outcomes and high success rate.
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July 2018

The Effect of Orthognathic Surgery on Osteoprotegerin as Immunological Caliper of Bone Healing.

Open Access Maced J Med Sci 2016 Dec 22;4(4):705-708. Epub 2016 Nov 22.

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Background: Osteoprotegerin (OPG) is considered to be the cytokine that plays an important role in the healing process. OPG regulates bone cell biology, osteoblast-osteoclast, bone-immune cross-talk and maintenance of bone mass. It plays an important role in the development, induction, and repair of bone. Orthognathic surgery as multiples segmental osteotomies has been taken as a model surgery to assess the changes in osteoprotegerin levels in the post-operative bone healing period.

Aim: The aim of the study was to evaluate OPG as immunological caliper of bone healing.

Material And Methods: OPG was evaluated in nine patients seeking orthognathic surgery. Patients were examined and checked to be medically and immunologically free prior to surgery. Blood samples were collected immediate pre-operative as control group and for six weeks post-operative as study group.

Results: Data were collected from nine consecutive patients. The results showed higher levels of OPG. it showed significant increase in the immediate post-operative value (p = 0.001) which started to increase gradually during the six weeks (p < 0.001).

Conclusions: Significant higher levels of OPG during the healing period of orthognathic surgery suggest the its use as immunological caliper of bone healing.
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December 2016

Grafted tubularised incised-plate urethroplasty: An objective assessment of outcome with lessons learnt from surgical experience with 263 cases.

Arab J Urol 2016 Dec 27;14(4):299-304. Epub 2016 Oct 27.

Department of Pediatric Surgery and Urology, Ibn Sina Hospital, Kuwait City, Kuwait.

Objective: Snodgrass urethroplasty remains the preferred technique in primary distal hypospadias but development of meatal stenosis often limits distal extension of the midline incision of the urethral plate (MIUP), which remains a limiting factor in reconstructing an apical neomeatus (NM). We here-in assess the cosmetic and functional outcome with distal extension of the MIUP in grafted tubularised incised-plate urethroplasty (G-TIP) repair.

Patients And Methods: This prospective study included the surgical experience of 263 cases of primary hypospadias operated upon between 2012 and 2015. The G-TIP technique included standard steps of Snodgrass urethroplasty, including degloving and harvesting of glans wings, followed by MIUP that was extended distally beyond the margins of the urethral plate (UP) into the glans. The incised bed was grafted with a free preputial skin graft and fixed to the bed with polydioxanone 7-0 suture. The UP was tubularised and the suture line reinforced with a Dartos flap. The urethral catheter was removed at 7-10 days after the repair and the outcome was assessed at follow-up using the Hypospadias Objective Scoring Evaluation (HOSE) system.

Results: An apical NM was achieved in 96% of the patients with a 3.7% incidence of urethrocutaneous fistula. The presence of suture tracks and graft at the margins of the NM were seen in the initial 4% and 5% of cases, respectively. Acceptable cosmetic results, with objective HOSE scores of >14, were achieved in 96% of cases.

Conclusion: The G-TIP repair is a straightforward and feasible technique facilitating reconstruction of an apical NM, with an optimum outcome based on HOSE scoring. However, multicentre data are needed for undertaking comparative analysis and to assess the universal applicability of this technique in primary hypospadias.
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December 2016

Urethroplasty for treatment of long anterior urethral stricture: buccal mucosa graft versus penile skin graft-does the stricture length matter?

Int Urol Nephrol 2016 Nov 11;48(11):1831-1835. Epub 2016 Jul 11.

Urology Department, Sohag Faculty of Medicine, Sohag University Hospital, Sohag University, Sohag, Egypt.

Purpose: To investigate the surgical outcomes of dorsal onlay urethroplasty (DOU) using buccal mucosa graft (BMG) or penile skin graft (PSG) and to assess the effect of stricture length in men with anterior urethral strictures.

Methods: A prospective cohort included men with anterior urethral strictures between 2008 and 2015. Patients underwent DOU using PSG or BMG. Patients had urethrography and uroflowmetry at 0, 3, 6, 12 months, and urethroscopy when needed. Student's t test, Mann-Whitney U tests, and Pearson's Chi-square test were used for analysis.

Results: Sixty-nine patients (43 ± 14 year) were included, 31 received BMG, and 38 received PSG. Mean stricture length was 8 ± 3 cm, mean operative time was 145 ± 31 min, and mean follow-up was 56 ± 10 mo. Success rate was 87 % (90 % BMG vs. 84 % PSG, p = 0.4). Mean operative time was significantly shorter in PSG group (136 ± 29 min vs. 256 ± 58 min, p = 0.0005). Complications of grade I developed in 36 % (wound infection = 10 %, postvoiding dribbling = 18.8 %). Thirty of 69 patients (43 %) had strictures ≥8 cm, and 39 (57 %) had strictures <8 cm-success rate was equal for both subgroups (87 %). Mean blood loss, mean operative time, and incidence of postvoid dribbling were significantly lower in strictures <8 cm.

Conclusion: BMG and PSG have comparable success rates in treatment of long anterior urethral strictures. Operative time is significantly longer in BMG. Long-segment strictures are associated with longer operative time, more blood loss, and more occurrence of postvoid dribbling. However, the length of the stricture has no influence on the success rate and functional outcomes of DOU.
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November 2016

A "copolymer-co-morphology" conception for shape-controlled synthesis of Prussian blue analogues and as-derived spinel oxides.

Nanoscale 2016 Jan;8(4):2333-42

State Key Laboratory of Catalysis, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China.

The morphologically and compositionally controlled synthesis of coordination polymers and spinel oxides is highly desirable for realizing new advanced nanomaterial functionalities. Here we develop a novel and scalable strategy, containing a "copolymer-co-morphology" conception, to shape-controlled synthesis of various types of Prussian blue analogues (PBAs). Three series of PBAs MyFe1-y[Co(CN)6]0.67·nH2O (MyFe1-y-Co, M = Co, Mn and Zn) with well-controlled morphology have been successfully prepared through this strategy. Using MnyFe1-y-Co PBAs as the model, by increasing the relative content of Mn, flexible modulation of the morphology could be easily realized. In addition, a series of porous MnxFe1.8-xCo1.2O4 nano-dices with well-inherited morphologies and defined cation distribution could be obtained through a simple thermal treatment of the PBAs. All these results demonstrate the good universality of this novel strategy. When evaluated as an electrocatalyst, the octahedral-site Mn(III)/Mn(IV) content in MnxFe1.8-xCo1.2O4, mainly determined by sensitive (57)Fe Mössbauer in combination with X-ray photoelectron spectroscopic techniques, was discovered to be directly correlated with the oxygen reduction/evolution reaction (ORR/OER) activity.
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January 2016

Is combined inner preputial inlay graft with tubularized incised plate in hypospadias repair worth doing?

J Pediatr Urol 2015 Aug 12;11(4):229.e1-4. Epub 2015 Jun 12.

Pediatric Urology Unit, Ibn Sina Hospital, Kuwait.

Background: It has been noted that after tubularized incised plate urethroplasty (TIP) repair, the final meatal position is glanular but not at the optimum position. Inner preputial inlay graft combined with tubularized incised plate (G-TIP) has been proposed for redo urethroplasty. We extended this indication to be the standard technique for primary hypospadias repair. We conduct this prospective study to obtain a wide, slit-like appearance neomeatus at the optimum position in the glans proper and to judge if hypospadias repair complications differ from TIP repair in the published data in the literature.

Patients And Methods: This prospective study included 230 consecutive patients who underwent this technique. The study was conducted from November 2011 to August 2014 for all hypospadias cases to be repaired in a single stage regardless of the width and depth of urethral plate or the glans size and shape. Localization of the meatus was glanular in 13 patients, coronal in 75, distal penile in 112, mid penile in 25 and proximal in five. The urethral plate was incised deeply and extended distally beyond the end of the plate by 3 mm in glans proper. The mucosal graft was harvested from the inner prepuce, inlayed and quilted in the incised urethral plate. The neourethra was created over a urethral catheter in two layers. The vascular dartos flap was mobilized dorsally and moved ventrally to cover the neourethral suture line as a barrier.

Results: The follow-up period ranged from 5 to 36 months. Excellent cosmetic and functional results were achieved in 221 of 230 patients (96.09%). Neither meatal stenosis nor urethral diverticulum were encountered. An excellent glanular position of a wide slit-like neomeatus was achieved using this technique. Nine patients (3.91%) developed urethrocutaneous fistula. Excellent urinary stream was reported by parents.

Conclusions: Combined inner preputial graft with TIP urethroplasty secures the optimal glanular position of a wide slit-like neomeatus because of extension of the incision beyond the end of the plate, thus optimizing functional and cosmetic outcome with no meatal stenosis.
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August 2015

Evaluation of some pollutant levels in environmental samples collected from the area of the new campus of Taif University.

Isotopes Environ Health Stud 2013 8;49(1):132-51. Epub 2012 May 8.

Physics Department, Faculty of Science, Taif University, Taif, Saudi Arabia.

The levels of radioactivity and heavy metals in soil, plant and groundwater samples collected from the area of the new campus of Taif University, Saudi Arabia, and its neighbouring areas have been determined. High-resolution gamma-ray spectroscopy was used for radioactivity measurements, and inductively coupled plasma atomic emission spectroscopy was used to determine the concentration of heavy metals. The means of (226)Ra, (228)Ra and (40)K concentrations in water samples collected from four wells were found to be 0.13 ± 0.03, 0.05 ± 0.03 and 1.3 ± 0.5 Bq l(-1), respectively. The means of (238)U, (226)Ra, (228)Ra ((232)Th for soil samples) and (40)K concentrations in wild plant and soil samples were found to be 3.7 ± 4.1, 8.8 ± 11.6, 3.8 ± 2.9 and 1025 ± 685, and 8.6 ± 3.4, 12.8 ± 3.4, 16.6 ± 7.1 and 618 ± 82 Bq kg(-1) dry weight (DW), respectively. The (137)Cs of artificial origin was also detected in soil samples with a mean concentration of 3.8 ± 2.2 Bq kg(-1) DW. Evaluating the results, it can be concluded that the concentrations of (238)U, (226)Ra, (232)Th and (40)K in soil samples fall within the world average. Furthermore, 19 trace and major elements in groundwater samples and 22 elements in soil and plant samples were determined. The sampling locations of soil can be classified into three groups (relatively high, medium and low polluted) according to their calculated metal pollution index using the contents of trace and major elements. A cluster analysis of the contents of radioactivity and trace element contents in soil samples shows the presence of two main distinct clusters of sampling locations.
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August 2013

Combined bony closure of oroantral fistula and sinus lift with mandibular bone grafts for subsequent dental implant placement.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011 Apr;111(4):e8-14

Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

Sinus lifting and reconstruction of localized alveolar defects are often required after closure of a large oroantral fistula (OAF) to allow for subsequent implant installation. This study describes a combined surgical technique that involves sinus lifting, bony closure, and reconstruction of the alveolar defect at the site of an OAF. The sinus membrane was reconstructed as a continuous layer by combining the residual sinus membrane with a rotated part of oral mucosa around the OAF. Autogenous bone from the chin and/or ramus was grafted into the prepared sinus space and alveolar defect, and the graft was covered by a buccal advancement flap. This technique was used to treat 8 patients who had large OAFs in the posterior maxillary region. The treatment was successful in all cases, and the technique appears to be suitable for large OAFs where implants are subsequently desired.
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April 2011