Osamah Mohammed Aldaghir

Purpose The aim of this study is to assess the effectiveness of maxillary cortical bone graft chips harvested by bone scraper, covered with platelet-rich fibrin (PRF) in alveolar clefts. Patients and methods Seventy-two cleft patients were examined for their eligibility to be part in this comparative study; they were randomly divided into group A, thirty-six patients had received cancellous bone chips from iliac crest; group B, thirty-six had received cortical bone chips harvested from maxilla using a curved bone scraper, covered with PRF. The clinical success over the follow-up period was evaluated on the basis of elimination of the oronasal fistula, radiographic assessment of bone graft volume, achievement of the osseous continuity of the alveolar arch, and the extent of the vertical bone height. Results The mean of volume gained in group A was 0.8053 ± 0.9682, while for group B was 0.7397 ± 0.7703. The amount of vertical bone loss between groups was registered, and the chi-square test revealed insignificant differences between study groups (p = 0.547). The result of the frequency of fistula development after grafting in both groups was insignificant (p = 0.074). Also, for the continuity of the maxilla as a one piece, the results were insignificant differences between study groups (p = 0.058). Conclusion In conclusion of our study, intraoral harvesting of maxillary cortical chips by bone scraper covered with PRF is able to achieve a valid functional and aesthetic support in alveolar cleft patients, meeting the reconstructive goals.

Background. The presence of black triangles around the dental implant‐supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri‐implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U‐shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al‐Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U‐shaped flap without rolling was used in conjunction with temporary crown placement; group B: at the second stage of implant surgery, a U‐shaped flap with rolling was used in conjunction with temporary crown placement. Then, the temporary crown was fabricated for both groups and kept in place for one month. Two independent maxillofacial surgeons evaluated all patients two weeks after the cementation of the final zirconia crown for the implant soft tissue esthetic score. Results. The highest possible score assigned to the mesial papilla (2 scores) was present in 92.5% of the group A patients and only 77.5% of the group B patients. Moreover, we have found that alveolar bone contour is achieved perfectly (2 scores) in 70% of group A patients but only in 32.5% of group B patients. Conclusion. The U‐shaped flap without rolling with a temporary crown is a simple technique. It has good results, especially when there is no severe resorption of the labial bone plate (in canine and premolar areas).

purpose: The aim of this study is to assess the effectiveness of maxillary cortical bone graft chips harvested by bone scraper, covered with platelet rich fibrin (PRF) in alveolar cleftsPatients and methods: Seventy-two cleft patients were examined for their eligibility to be part in this comparative study, they were randomly divided into: group A, thirty-six patients had been received cancellous bone chips from iliac crest, group B, thirty-six had been received cortical bone chips harvested from maxilla using a curved bone scraper, covered with PRF.The clinical success over the follow-up period was evaluated on the basis of elimination of the oronasal fistula, radiographic assessment of bone graft volume, achievement of the osseous continuity of the alveolar arch, and the extent of the vertical bone height.Results The mean of volume gained in group A was (0.8053, +_ 0.9682), while for group B was (0.7397, +_ 0.7703). the amount of vertical bone loss between groups were registered, the chi-square test revealed insignificant differences between study groups (P =0.547). the result of the frequency of fistula development after grafting in both groups was insignificant (p=0.074). Also, for the continuity of the maxilla as a one piece the results were insignificant differences between study groups (p=0.058).Conclusion: In conclusion of our study, Intraoral harvesting of maxillary cortical chips by bone scraper covered with PRF is able to achieve a valid functional and aesthetic support in alveolar cleft patients, meeting the reconstructive goals.

Purpose: The aim of this retrospective study was to study the effects of the war against ISIS during period (2014–2018) on the incidence of cleft lip and palate and the appearance of different congenital anomalies. Materials and Methods: The collected sample consists of 320 newborn babies (160 patients and 160 infants as a control). The examined patients and controls were all included in this study, while the authors exclude those who born to relative parents, and if the mothers had taken any medications during pregnancy. All newborn cases and controls were physically examined by the research team, and a questionnaire was completed after obtaining the informed consent of mothers and/or fathers. Results: In this study, the authors found that 160 patients out of 40,500 live births were born with cleft lip and/or cleft palate, so their percentage was 0.39% from population, that is mean approximately 4 infants affected per each 1000 live births. The risk of cleft development among children who born to fathers who participated in long fighting against the terrorists was (OR = 44.333, 95% CI: 20.176–97.417). The associated combined anomalies were found in 88 patients (79%) especially among those whom fathers participated in the war Conclusion: From this study the authors can conclude that the dramatic increase in the incidence of cleft lip and palate and the appearance of different associated anomalies in the south of Iraq is due to the direct effect and impact of the war and the used toxic bombs on the chromosomal changes of the parents and the developing fetus.

Dedicator of cytokinesis 8 (DOCK8) deficiency (MIM #243700) is a rare disease, leads to a combined primary immunodeficiency (PID), and accounts for the autosomal recessive-hyper immunoglobulin E syndrome (AR-HIES). DOCK8 deficiency status characterizes by recurrent infections, atopy, and risk of cancer. Lymphoproliferative disease complicating PID, is difficult to diagnose. Our aim is to present a rare case of PID, and to the best of our knowledge, she is the first case of DOCK8 deficiency from Iraq. The genetic diagnosis was carried out in Japan using dried blood spot-based DNA transfer and whole-exome sequencing. An 11-year-old Iraqi girl, of double first-cousin-parents, had a history of severe eczema, food allergy, and repeated infections. She presented with a jaw mass, bilateral cervical and axillary lymphadenopathy, and immunoglobulin (Ig) assays of 20, 3.3 and 1.7-fold above maximum normal level for age of IgE, IgA and IgG, respectively, along with a low IgM, eosinophilia and lymphopenia. Based on the jaw mass biopsy, non-Hodgkin lymphoma was suggested in Iraq, whereas histopathological re-evaluation in Japan revealed the diagnosis of a polyclonal reactive proliferation spectrum of lymphoproliferative disorders/plasmacytic hyperplasia, complicating PID. Whole-exome sequencing supported the diagnosis of PID by identifying a homozygous DOCK8 mutation with previously reported pathogenicity (NM_203447:c.3332delT, p.Phe1113Leufs*2), that may be attributed to consanguinity. International collaboration using an effective DNA transportation technique and next-generation sequencing was the key to pinpoint the diagnosis of DOCK8 deficiency. Our case asserted that careful pathogenetic evaluation, in an advanced setting, was crucial for ruling out the neoplastic process. Pediatricians in areas with a high prevalence of consanguinity marriage should have a high index of suspicion of DOCK8 deficiency in patients with recalcitrant eczema, and frequent respiratory and skin infectious episodes.