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Background The innovation of leukocyte platelet-rich fibrin (L-PRF) has added enormous impact on wound healing dynamics especially the field of periodontal regeneration. The release of growth factors (GF) is thought to improve the clinical outcomes in infrabony defects. The aim of this study was to evaluate the clinical effect of covering L-PRF contained infrabony defects with collagen membranes (CM), and to compare their GF release profile to uncovered L-PRF defects and open flap debridement (OFD). Methods Thirty non- smoking patients with infrabony pockets participated to be randomly assigned to OFD group ( n  = 10), L-PRF group ( n  = 10), or L-PRF protected CM group ( n  = 10). Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and the radiographic defect base fill (DBF) were measured at baseline and at 6 month following surgical intervention. Gingival crevicular fluid samples were obtained on days 1, 3, 5, 7, 14, 21 and 30 days following surgery for the Platelet Derived Growth Factor-BB (PDGF-BB) and Vascular Endothelial Growth Factors (VEGF) release profile evaluation. Results For all patients, a statistically significant (P ≤ 0.05) reduction in PI, GI, PD and CAL were reported throughout the study period. Differences between the three treatment modalities were not statistically significant. PRF + CM showed a statistically significant DBF compared to OFD and L-PRF groups at follow up. Quantitative analysis of PDGF-BB and VEGF levels demonstrated a statistically significant ( P  < 0.001) decline between measurement intervals for all groups with no statistically significant differences between the three groups. Conclusion Within the limitations of this study, L-PRF coverage with CM may augment defect base fill through its mechanical protective effect without enhancement in the release profile of VEGF and PDGF. The non-significant intergroup differences question the validity of the claimed extra physiologic concentration of GF offered by L-PRF harvests. Trial registration The present study was registered at ClinicalTrials.gov (NCT05496608), (11/08/2022).

Purpose To evaluate early versus conventional loading in immediate implants for molars. This study aims to answer the following PICO (Patient, Intervention, Comparison, and Outcome) question: In patients over 18 years of age, does early loading of immediately placed implants in molar areas result in a similar implant survival rate and marginal bone loss as conventional loading? Methods Twenty-seven patients (15 women and 12 men) received a total of 30 implants immediately after molar extraction. The surgical treatment protocol entailed atraumatic tooth extraction without flap elevation. Non-invasive quantitative analyses were used to assess implant stability. After an uneventful healing period, the 30 implants were restored with screw-retained monolithic zirconia prosthesis, half of which after 6 weeks (G1) and the other half after 3 months (G2). Results Regarding the survival rate, the Kaplan–Meier and log-rank test showed that there was no statistically significant difference between both groups ( p  = 1). Implant stability quotient at the prosthetic phase of both groups (6 weeks in G1 and 3 months in G2) revealed no statistically significant difference (G1 RFA74.4 (SD 5.54) − DCA 79.07 (SD 5.75))/G2 RFA 73.67 (SD 5.7), − DCA78.93 (SD 4.48). Conclusions Early loading of immediately placed implants in molar sites is considered a predictable treatment modality provided that ideal implant position and adequate insertion torque are achieved.

This study examines the effect of a hyaluronic acid (HyAc) containing tricalcium phosphate putty scaffold material (TCP-P) and of a particulate tricalcium phosphate (TCP-G) graft on bone formation, volume stability and osteogenic marker expression in biopsies sampled 6 months after bilateral sinus floor augmentation (SFA) in 7 patients applying a split-mouth design. 10% autogenous bone chips were added to the grafting material during surgery. The grain size of the TCP granules was 700 to 1400 µm for TCP-G and 125 to 250 µm and 500 to 700 µm (ratio 1:1) for TCP-P. Biopsies were processed for immunohistochemical analysis of resin-embedded sections. Sections were stained for collagen type I (Col I), alkaline phosphatase (ALP), osteocalcin (OC) and bone sialoprotein (BSP). Furthermore, the bone area and biomaterial area fraction were determined histomorphometrically. Cone-beam CT data recorded after SFA and 6 months later were used for calculating the graft volume at these two time points. TCP-P displayed more advantageous surgical handling properties and a significantly greater bone area fraction and smaller biomaterial area fraction. This was accompanied by significantly greater expression of Col I and BSP and in osteoblasts and osteoid and a less pronounced reduction in grafting volume with TCP-P. SFA using both types of materials resulted in formation of sufficient bone volume for facilitating stable dental implant placement with all dental implants having been in function without any complications for 6 years. Since TCP-P displayed superior surgical handling properties and greater bone formation than TCP-G, without the HyAc hydrogel matrix having any adverse effect on bone formation or graft volume stability, TCP-P can be regarded as excellent grafting material for SFA in a clinical setting. The greater bone formation observed with TCP-P may be related to the difference in grain size of the TCP granules and/or the addition of the HyAc.

Background Many forms of bronchoscopic lung volume reduction were introduced as a treatment for patients with emphysema surpassing the surgical management and its fatality. Biological bronchoscopic lung volume reduction (BBLVR) proved to be a safe and competent solution inducing collapse of the emphysematous segment(s). Impulse oscillometry (IOS) constitutes an effortless but underused surrogate to spirometry in assessment of pulmonary function. Therefore, the aim of this study was to evaluate the use of IOS before and after BBLVR with histoacryl gel in comparison with spirometry among patients with emphysema. Patients and methods A prospective comparative follow-up study was performed at Kobry El-Kobba Military Hospital. A total of 30 patients with radiological evidence of heterogenous emphysema or emphysematous bullae were enrolled during the period from July 2014 to April 2015. BBLVR was accomplished by the instillation of the histoacryl gel into the affected segment(s) using standard technique. Clinical, radiological, and functional assessments were done before and 4 weeks after the procedure. Results After BBLVR, the following outcome was measured: 6-min walk test, partial pressure of O 2 in arterial blood, forced expiratory volume in the first second, resistance at 5 Hz, resistance at 20 Hz, and reactance at 5 Hz. They improved with statistical significance among all the patients. There was a negative correlation between forced vital capacity and resistance at 5 Hz in the heterogenous emphysema group ( ρ =0.47 and P <0.025); however, the forced expiratory volume at first second showed positive correlation with reactance at 5 Hz in emphysematous bullae group ( ρ =0.82 and P <0.023). Conclusion BBLVR with histoacryl gel is associated with improvement in exercise capacity and lung functions. IOS provided comprehensive assessment of the pulmonary functions, which was in good correlation with spirometry.

Punicalagin (PUN) is a major bioactive ellagitannin derived from pomegranate and showed a potential anticancer property on several cell lines, no studies investigate its effect on tongue carcinoma cells. The present study aimed to evaluate the cytotoxic and antiangiogenic effects of PUN on human tongue carcinoma cell line. The viability of the tongue carcinoma cell line was assessed following treatment with PUN (250, 200, 150, 100, and 50 µmol) for 24 h using MTT assay. In addition, the calculated (IC 50) was used for apoptosis validation using Annexin-V/Propidium Iodide (PI) flow cytometry, angiogenesis investigation using endothelial tube formation assay, and transforming growth factor-β (TGF-β) expression on human tongue carcinoma cells after treatment with Punicalagin using quantitative real-time polymerase chain reaction (qRT-PCR). The vitality of tongue carcinoma cells treated with PUN was 61.1 ± 4.36% and the untreated cells were 98 ± 2%. Flow cytometry confirmed that treatment with 185 µmol/mL of PUN induced significant apoptosis, yielding 51.3% apoptotic cells, 2.3% necrotic cells, and 46.7% viable cells. Regarding tubules no. HPF Untreated cells had a statistically significant higher value (5.83 ± 1.94) than cells treated with PUN (3.17 ± 1.17) ( p  = 0.023). The junction no/HPF had a higher value in untreated cells (5.50 ± 2.43) than in cells treated with PUN (3.33 ± 1.37) yet the difference was not statistically significant ( p  = 0.119). The Tube length showed a statistical significance between untreated cells (5.28 ± 0.77) and cells treated with PUN (1.83 ± 0.26) ( p  = 0.004). The values for lobules no/HPF were higher in untreated cells (2.67 ± 0.52) than in cells treated with PUN (1.67 ± 0.82) yet the difference was not statistically significant ( p  = 0.053). The expression of TGF-β gene showed a significantly higher value in untreated cells (0.97 ± 0.03) than in cells treated with PUN (0.02 ± 0.01) ( p  = 0.004). These initial in vitro observations indicate an anticancer effect of PUN on tongue carcinoma cells through the induction of apoptosis and inhibition of cell viability and angio-mimetic tube formation, closely correlating with the downregulation of TGF-β gene expression. This provides a possible preliminary therapeutic direction to the study of tongue carcinoma.

Introduction Horizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling. Case presentation A healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement. Conclusion DLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.

Objective This study aimed to evaluate the clinical performance (degree of trueness) of a novel scan body “tooth-modified Scan body” (TMSB)& conventional scan body (CSB) in implant-supported full arch screw retained cases. Methods Seven edentulous arches (two maxillae, five mandibles) in 6 patients were rehabilitated with monolithic zirconia screw-retained implant prostheses supported by 4 ( n  = 1) and 5 implants ( n  = 6) for a total amount of 34 implants. Implant locations were scanned by intra-oral scanner (IOS) using two types of scan bodies, conventional scan bodies (CSB) in group (1) and tooth-modified scan bodies (TMSB) in group (2). 68 implant positions (representing the total sample size) were captured and compared to the relative reference scans regarding angular and Euclidian deviation (ΔEUC). Results The ΔEUC deviation Of TMSB group had lower values (M = 61.46, SD = 42.12) than that Of CSB group (M = 97.97, SD = 56.69). This difference was statistically significant ( p  = .005), 95% Confidence interval. The angular deviation of TMSC group had lower values (M = 0.85, SD = 0.69) than that Of CSB group (M = 1.3, SD = 1.06) which was statistically significant ( p  = .033), 95% Confidence interval. There was a correlation between the type of Jaw and both angular and ΔEUC deviation of both groups, which was statistically significant. Conclusion A tooth-modified scan body (TMSB) may improve the ease and trueness of full-arch implant scanning, even in challenging mandibular arches. Clinical trial registry date Retrospectively registered in 20/ 12/ 2023. Clinical trial registry number NCT06177782.

Purpose - The purpose of this paper is to understand the use of strategic planning tools and techniques by hotels in Jordan and the nature of its relationship with managers' views of the strategic planning process.Design methodology approach - A review of the literature relating to both strategic planning and strategic planning tools and techniques in both developed and emerging markets is provided. The empirical research was conducted via a questionnaire survey of Jordanian hotels in two cities; namely, Petra and Aqaba.Findings - The main findings of this research are that the Jordanian hotels engage in the strategic planning process by using a number of techniques. The use of strategic planning tools and techniques relates more to the size of hotel and less to age and ownership type. There is a positive relationship between the use of strategic planning techniques and size of hotel. The managers of these hotels have generally positive attitudes towards the strategic planning process. The managers who believe in the benefits of strategic planning engage more in the practice of it.Research limitations implications - The nature of this research is descriptive and the method used is a cross-sectional survey. Therefore, future research could be conducted on a small number of these hotels by using a more in-depth approach. Second, the sample was restricted to hotels in two cities in Jordan. Further research should include other regions in Jordan and should analyse the ownership types of hotels (such as independent versus chain) and its star rating.Originality value - This paper provides empirical evidence about the use of the strategic planning tools and techniques by hotels in an emerging market context.

Objective This clinical trial was conducted to compare the four types of static fully guided surgical guides (bilateral tooth-supported guides, unilateral tooth-supported guides, mucosa-supported complete arch guides, and stackable bony-supported guides) in terms of accuracy. Aim To compare all static guided protocols (bilateral tooth supported, unilateral tooth supported, full arch mucosa supported, stackable bone supported) with each other under homogenous conditions, accuracy is defined as the closeness of spatial agreement between any given implant as planned (reference) and as inserted (measurement), expressed by four spatial deviation parameters. Methods All patients in this investigation underwent a cone beam computer tomography with standard settings. Meanwhile, digital impressions were taken by an intraoral scanner. Implant planning software was used, considering a prosthetic-driven approach. Fully guided surgeries were executed. To evaluate the four groups of fully guided surgical guides, a digital imprint was obtained immediately after surgery. All STL files were imported into CAD software, and a digital library translated scan bodies to implant fixture replicas. For trueness tests, new STL files were loaded into an inspection program. Results A single experienced surgeon inserted 86 implants using four different types of fully guided surgical guides. For the angular deviation, the Kruskal-Wallis test showed that there was no significant difference ( P =.117). In contrast, for the coronal global and apical global deviations, as well as the vertical discrepancies, there was a statistically significant difference between the four groups ( P =.022), ( P =.018), ( P < .001), respectively. A Dunn-Bonferroni test was used to compare the groups in pairs to identify any significant differences. Conclusions Given the limitations of this study, the trueness of the four categories of fully guided surgical guides falls within an acceptable range. Nevertheless, when utilizing mucosa-supported and stackable guides, operators should consider inherent deviations and exercise heightened vigilance. Clinical Trial Registry Date 27. 04. 2025. Clinical Trial Registry Number NCT06947057.

Objective This study aimed to correlate the dimensions of the maxillary sinus in CBCT-reformatted panoramic radiographs to the greater palatine canal geometry and its neighbor structures in CBCT multiplanar images, so considering the limitations of the current study, we could use panoramic radiographs as an alert tool before performing a variety of implant surgical and dental procedures concerning the Greater Palatine Canal (GPC). Methods The GPC pathway and its neighbor structures were assessed in a sample of 48 CBCT Egyptian adult patients’ images (24 females and 24 males) in the three orthogonal planes and correlated to the height, width and hypothetical surface area of the maxillary sinus (MS). Results There was a statistically significant difference in sagittal planes among genders regarding GPC pathway, as Type a was the most prominent GPC pathway among females (an antero-inferior direction) in contrast to male cases that shown Type c (posterior-inferior direction, then an anterior-inferior direction) pathway. Male patients had significantly lower GPC angle than female patients ( P  = 0.022). Males had greater mean values of MS height, width & hypothetical surface area than females. The greater the GPC angle in sagittal plan, the lesser MS height, width & hypothetical surface area. In addition, MS of greater height had more posterior extension (depth). Conclusion Considering the restrictions of the current retrospective study, the current study illustrated a significant correlation between maxillary sinus (MS) dimensions and greater palatine canal (GPC) anatomy, specifically the GPC pathway and angle. Larger MS (especially height) correlated with GPC with more posterior pathway and lesser angle, which is sex-based association. These findings are with great clinical significance to minimize the risk of GPC neurovascular bundle iatrogenic injury during interventions dealing with posterior maxilla, particularly sinus lifts, implant planning, due to potential impingement from MS expansion.