Publications by authors named "Hamdy Marzook"

7 Publications

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Endodontic remnants are found more than other radiopacities in proposed implant sites.

Int J Implant Dent 2021 Apr 2;7(1):33. Epub 2021 Apr 2.

Conservative Dentistry Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt.

Background: Foreign bodies may be a cause of concern in dental implant failure.

Purpose: The aim of the present study was to assess the occurrence and to evaluate the types of radiopacities in dental extraction sites using cone beam computed tomography (CBCT).

Materials And Methods: The incidence, location, and types of radiopacities were evaluated in 180 CBCT scans.

Results: Different radiopaque structures could be noted in 84 scans. Foreign bodies and remaining roots were frequently seen. Most of the radiopacities were attributed to remaining endodontic filling in upper and lower jaws in 25 scans in different locations. Remaining roots could be detected in 20 scans. Focal and diffuse radiopaque bony lesions were observed in 16 scans. Tissue response in the form of radiolucency could be seen more with endodontic foreign bodies. Tissue reactions to radiopaque filling remnants were seen in 6.11% of cases.

Conclusions: Foreign body remnants, mostly of endodontic fillings, were frequently seen in CBCT in upper and lower jaws. Evidence of tissue reactions to extraction remnants could be found. Endodontic filling remnants could be seen more in the upper jaw. Thorough examination of implant site for the presence of endodontic foreign body remnants should be stressed. Debridement of the extraction socket should be done carefully in endodontically treated teeth.
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April 2021

Median Perforating Canal in Human Mandible.

J Craniofac Surg 2019 Jul;30(5):e430-e432

Oral Biology Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt.

Surgical interventions in the anterior region of the human mandible are associated with many complications. Some anatomical structures like the median perforating canal were discovered in mammals. Such canals may be a cause of concern that needs attention in human mandible. The purpose of the present study was to evaluate the occurrence, location, and course of median perforating canal and its associated extensions in the anterior segment of the human mandible in cone beam computed tomography scans (CBCT). Data were collected from 160 CBCT scans, and evaluated. The incidence was 23.75% for median perforating canal with wide anatomical variations concerning the related lingual and labial extensions. Median perforating canal and their associated lingual and labial foramina are frequently seen in human mandible. A thorough investigation of the symphyseal region using CBCT must be taken into account when targeting surgical intervention in this area.
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July 2019

Angulated Dental Implants in Posterior Maxilla FEA and Experimental Verification.

Open Access Maced J Med Sci 2018 Feb 14;6(2):397-401. Epub 2018 Feb 14.

National Research Centre - Mechanical Engineering, Giza 12622, Egypt.

Aim: This study aimed to evaluate the effect of different implant angulations in posterior maxilla on stress distribution by finite element analysis and verify its results experimentally.

Methods: Two simplified models were prepared for an implant placed vertically and tilted 25° piercing the maxillary sinus. Geometric models' components were prepared by Autodesk Inventor then assembled in ANSYS for finite element analysis. The results of finite element analysis were verified against experimental trials results which were statistically analysed using student t-test (level of significance p < 0.05).

Results: Implant - abutment complex absorbed the load energy in case of vertical implant better than the case of angulated one. That was reflected on cortical bone stress, while both cases showed stress levels within the physiological limits. Comparing results between FEA and experiment trials showed full agreement.

Conclusion: It was found that the tilted implant by 25° can be utilised in the posterior region maxilla for replacing maxillary first molar avoiding sinus penetration. The implant-bone interface and peri-implant bones received the highest Von Mises stress. Implant - bone interface with angulated implant received about 66% more stresses than the straight one.
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February 2018

Clips vs Resilient Liners Used With Bilateral Posterior Prefabricated Bars for Retaining Four Implant-Supported Mandibular Overdentures.

J Oral Implantol 2017 Aug 19;43(4):273-281. Epub 2017 Jun 19.

2   Department of Oral Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.

The objective of this research was to clinically compare peri-implant tissue health of bar-clips vs silicone-resilient liners used with bilateral posterior bars for retaining 4 implant-supported mandibular overdentures. Thirty completely edentulous male patients (mean age, 65 years) were randomly assigned into 2 equal groups. Each patient received 4 implants in the canine and first molar regions of the mandible using a flapless surgical technique. Mandibular overdentures were immediately connected to the implants with bilateral prefabricated instant adjusting bars. According to the method of retention to the bar, 1 group was retained with clips (GI), whereas the other group was retained with a silicone-resilient soft liner (GII). Peri-implant tissue health was evaluated clinically in terms of plaque scores (MPI), bleeding scores (MBI), probing depth (PD), and implant stability (IS). MPI, MBI, and PD were measured at mesial, distal, buccal, and lingual surfaces of each implant. Evaluations were performed 2 weeks (T0), 6 months (T6), and 12 months (T12) after overdenture insertion. Implants of GI with clips demonstrated significant increase in plaque, bleeding, and PD scores compared with those of GII with silicone-resilient liner at all observation times. Implants in GI demonstrated a significant decrease in implant stability compared with those of GII at T6 and T12 anteriorly and at T12 posteriorly. Resilient liners are considered better than bar-clips when used with bilateral posterior bars for retaining implant-supported mandibular overdentures in terms of peri-implant soft tissue health. Bilateral posterior ready-made bars cannot be proposed as a promising design for supporting implant-assisted mandibular overdentures.
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August 2017

Experimental study on penetration of dental implants into the maxillary sinus at different depths.

Oral Maxillofac Surg 2016 Sep 9;20(3):281-7. Epub 2016 Jul 9.

Faculty of Dentistry, Mansoura University, Mansoura, Egypt.

Objective: The purpose of this study was to investigate the effect of the dental implant penetration into the maxillary sinus cavity in different depths on implant and sinus health in a dog model.

Materials And Methods: The study sample included eight titanium dental implant placed in four female dogs immediately after extraction of the first maxillary molar in the palatal socket and assigned into four groups according to the protruding of implant tips (control group A = 0 mm, and study groups B, C, and D with protrusion of 1, 2, and 3 mm, respectively). The bone blocks of the implants were harvested 5 months postoperatively and evaluated by cone beam computed tomography (CBCT) and histological analysis.

Results: The whole groups showed no signs of inflammation during the 5-month period of the study. The tips of the implants in group B with penetrating depths of 1 mm were found to be fully covered with newly formed bone. The tips of the implants in group C with penetrating depths of 2 mm were exposed in the sinus cavity and showed partially new bone coverage, while depths of 3 mm in group D were found to have no bone formation and the dental implant fixture sites were communicated with the sinus cavity. No significant differences were found among the groups regarding implant stability.

Conclusion: Despite the protrusion extents, penetration of dental implant into the maxillary sinus with membrane perforation does not compromise the sinus health and the implant in canine.
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September 2016

Modifying gummy smile: a minimally invasive approach.

J Contemp Dent Pract 2014 Nov 1;15(6):821-6. Epub 2014 Nov 1.

Associate Professor, Department of Oral and Maxillofacial Surgery, Dental College Mansoura University, Egypt.

Aim: Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile.

Materials And Methods: Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit.

Results: At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month.

Conclusion: This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile.

Clinical Significance: A non-invasive procedure to avoid other complicated surgical procedures.
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November 2014

Assessment of anodized titanium implants bioactivity.

Clin Oral Implants Res 2014 Feb 23;25(2):e1-9. Epub 2012 Nov 23.

Department of Dental biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.

Objectives: This study was conducted to create nanostructured surface titanium implants by anodic oxidation process aiming to bring out bioactivity and to assess the resultant bioactivity both in vitro and in vivo.

Materials And Methods: An economic protocol was used to apply anodic spark discharge and create surface nanoporosities on grade II commercially pure titanium (cpTi). The in vitro investigation included morphology, surface chemical analysis, roughness and crystalline structure of titanium oxide (TiO₂) film prepared. Assessment of the bioactivity was carried out by immersing the specimens in simulate body fluid (SBF) and investigating the surface-deposited layer. The in vivo investigation was conducted by surgically placing the anodized implants into rabbits tibia for different healing periods. Then biomechanical evaluation was performed to verify the effect of treatments on the interface resistance to shear force. Routine histological analysis was performed to evaluate the bone tissue reactions to anodized implants.

Results: Anodization of titanium implants produced morphological changes, raised the percentage of oxygen in the TiO₂ layer, increased surface area and roughness of implants remarkably, and modified the crystallinity of the film. The in vitro assessments of bioactivity showed that a layer of calcium phosphate was precipitated on the titanium surfaces 7 days after soaking into SBF. The implant-bone interface resistance to shear force was enhanced at 2-week healing period. This was confirmed by histological findings.

Conclusion: Nanostructured surface titanium implants could be prepared by anodic oxidation with resultant accelerated bioactivity that may be recommended for early loading.
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February 2014