Table of content

Al-Rafidain Dental Journal

مجلة الرافدين لطب الأسنان

ISSN: 18121217
Publisher: Mosul University
Faculty: Dentistry
Language: English

This journal is Open Access


Refereed Scientific Journal deals with fields of dental sciences
Date of first issue: 2001
No of Issues: 27 issues
publishing biannually till 2012
publishing becomes triannually at 2013

Contact info

University of Mosul
College of Dentistry - Deanery Building
Tel. 009647481705863

e mail:

Table of content: 2008 volume:8 issue:1

The Fracture Pattern of Different Mandibular Over–Denture Designs

Authors: Ahmed M. Hussein
Pages: 1-5

Aims: To evaluate the load at fracture for different mandibular over–dentures and the positions of the
fracture area for these designs. Material and methods: Ten mandibular dentures were made, each of
two designs. The first design consisted of acrylic resin over–denture supported by two dome–shaped 3
mm mandibular canines copings, the second design consisted of two dome–shaped copings connected
with a rigid metallic bar. The mean and standard deviation were calculated in addition to the analysis of
variance which showed a significant difference at P < 0.05. Results: Showed that the over–denture
supported by two dome shaped mandibular canines were more fracture resistance than the over–denture
supported with the bar. The fracture position depends on the denture design. Conclusions: The results
indicated that the denture made entirely of acrylic resin was much more stronger than the denture with
less thickness due to the incorporation on metallic rigid bar.

Reconditioning of Debonded Pure Titanium Bracket (Using Micro–etcher)


Aims: To evaluate the degree of change that may occur in reconditioning the titanium bracket via micro-
etcher. Materials and Methods: The sample consisted of (10) pure titanium brackets for each of
control and reconditioning brackets. The parameters of the reconditioned bracket (slot width, slot
depth, inter–wing gap, labio–lingual angle and base curvature angle) were measured and compared
with that of the control bracket. Results: The results showed no significant difference between the control
and reconditioned brackets of the slot parameters (width, depth, inter–win gap, labio–lingual angle)
and the bracket’s base curvature angle. While, the tensile bond strength of the control brackets
showed significantly higher mean value as compared with the recycled group. Conclusions: The reconditioning
of pure titanium brackets is recommended for reuse in the orthodontic treatment after sterilization.

The Effect of the Thermopress Curing Technique on the Water Sorption and Solubility of the Cold and Heat–Cured Acrylic Resins

Authors: Lamia T Rejab
Pages: 11-17

Aims: This study aims to evaluate the effect of the thermopress curing technique on the water sorption
and solubility of the cold–cured and heat–cured acrylic resins and compared this technique with the
bench curing technique used for the cold–cured resin and with the conventional water bath curing technique
for the heat–cured resin. Materials and Methods: they were to measure the water sorption and
solubility, the specimens were prepared as disks with a dimension according to the ADA Specification
No. 12. So specimens were divided into five groups depending on the type of the resin ( cold and heat–
cured ) methods of curing which were ( thermopress, conventional water bath and bench cure ) and the
time of curing cycle. Specimens were weighed before and after immersion in the distilled water and
after drying with silica gel using an electronic balance to measure the water sorption and solubility.
One way analysis of variance (ANOVA) followed by Duncan , s multiple range test was performed to
determined the significant different between the mean values among the tested groups at (p< 0.05)
level of significance. Results: There is a significant differences between the water sorption and solubility
of resin that cured by the different curing methods and different curing cycle times. The water
sorption and solubility of resin specimens that cured by thermopress have the higher values. Conclusions:
The water sorption and solubility of the cold and heat–cured acrylic resins is affected by the curing
method. The curing under higher pressure produces specimens with lower water sorption and solubility

The Effect of Premature Birth on The Primary Dentition


Aims: The aims of the present study were to determine if primary teeth eruption and the presence of
enamel defect are affected by low birth weight and prematurely of birth. Materials and Methods: The
total subjects of (420) child aged 4 – 24 months were included in this study, consisted of (210) prematurely
born (<37 gestational weeks and birth weight < 2.500 Kg) children and 210 control children (≥40
gestational weeks and birth weight ≥ 2.500 Kg). Those children selected randomly the children who
came to the primary health care centers with their mother for vaccination and the mothers asked to participate
in this study. For each child, clinical exanimation was performed in dental chair. The criterion
used for enamel defect to include various enamel hypoplasias, deficiency of enamel in the form of pits,
grooves or other quantitative surface loss and enamel hypocalcifications and opacities. Data were analyzed
using numbers, percentages, means and standard deviations. T – test, Z – test Chi – square (X2)
test were used for determining the differences concerning different variables. The differences were
considered significant at p≤ 0.05. Results: There was no significant difference (p>0.05) between different
genders numbers among in each age group for the preterm and control children. The results
showed significantly (p<0.05) delayed eruption of the primary teeth in the prematurely born children as
compared with the control children in all age groups except in 4 – 6 months age group, also there was
significantly higher percentages of enamel defect present in preterm children, than in control children
in all age groups except in 4 – 6 months age group. Conclusions: The findings indicated that the eruption
of deciduous teeth was delayed and the percentage of enamel defect was significantly increased in
prematurely born children.

Measurement of the Palatal Depth for Completely Edentulous Patient

Authors: Munther N Kazanje --- Saad Y INoori
Pages: 23-25

Aim: To measure the depth of the palate for completely edentulous patients and relate this parameter to the type of reflection of the soft palate. Materials and methods: Fixed reference point was determined in the hard palate of a hundred upper edentulous casts made by pouring impressions of completely edentulous patients attending the prosthodontic clinic in College of Dentistry, University of Mosul. This reference point was determined by drawing two lines, the first line from the center of incisive papilla to the fovea palatinae, and the second line crossing the first line exactly in its middle. The crossing point of these two lines was considered the point of measurement. A depth measuring digital vernia (Lezaco art, 2406 China) measuring to the nearest of 0.01 mm recorded the measurement. The curvature of soft palate was determined by measuring the angle formed by the highest point of the palate and a point one centimeter posterior to fovea palatinae. Results: The results showed that 65% of the measurements of the palatal depth fall in the moderate category of palatal depth and 79% of soft palate reflections were of gradual type. Conclusion: There is an acceptable success rate of complete denture could be achieved in cases of moderate palatal depth with gradual reflection of soft palate

Maxillary Arch Dimensional Changes in the Extraction and Non Extraction Orthodontic Treatment

Authors: Nada M Al–Sayagh
Pages: 26-37

Aims:To investigate whether extraction status and gender had any significant influence on the maxillary
arch dimensions. Materials and Methods: A sample of 40 orthodontic patients (20 extraction and
20 non extraction) were included in this study. Males and females were evenly represented in both
groups. All patients were treated with fixed edgewise appliances. Dental casts were taken before and
after final orthodontic treatment, fifteen maxillary arch parameters were evaluated at pre – and post –
treatment stage and included; dental arch width at the canine, 1st premolar, 2nd premolar, 1st molar (at
mesiobuccal and distobuccal cusp tips), arch depth at canine and 1st molar, arch lengths (incisal canine
length, canine molar length and incisal molar length ), and arch perimeter. A paired sample t– test was
used to evaluate the treatment changes in the extraction and non extraction groups and also to compare
between males and females before treatment and after treatment. Results: Generally, in both genders,
most pretreatment arch dimensions were not significantly different between extraction and non extraction
groups, while after treatment the extraction treatment resulted in the reduction in the arch perimeters,
arch depth, and arch length. Where as the non extraction group showed a significant increase in
most maxillary arch dimensions. In addition both the extraction and non extraction treatment did not
cause narrowing of the dental arch at the canine region. The direction of post treatment changes were
similar in male and female subjects. However, the magnitude of the post treatment changes in some
parameters differed significantly between females and males particularly in the non extraction group.
Conclusions: the extraction and non extraction groups showed similar trend in some maxillary dimensions
and different in other dimensions, thus it was concluded that the kind of treatment may affect the
maxillary arch dimensions. In addition the non extraction group had a larger number of significant
gender differences between females and males than the extraction group

The Effect of Microwave Disinfection on the Dimensional Change of Acrylic Resins.

Authors: Luay N Abbood --- Lamia T Rejab --- Ahmad M Hussen
Pages: 38-43

Aims: To evaluate the effect of the microwave disinfection on the dimensional changes of the heat–
cured acrylic resin. Materials and Methods: Heat–cured acrylic resin was used in this study. Thirty
two disk–shaped specimens with reference points were prepared to evaluate the linear dimensional
changes of the heat–cured acrylic resin that sterilized by microwave irradiation and by chemical
solutions chlorhexidine and sodium hypochlorite. The specimens were divided into four tested groups,
eight specimens for each group. Group I as control group and other groups divided according to the
sterilization method. The dimensional change was evaluated with an Electronic Digital Caliper. Mean
values wear compared statistically with: One–way Analysis of Variance (ANOVA), followed by
Duncan's Multiple Range Test to determine the significant different among the tested groups at
(p≤0.05) level of significance. Results: They showed that there was a highly significant difference of
the means values of the linear dimensional change among the four tested groups. Specimens sterilized
by microwave irradiation have a higher value than that sterilized by the chemical solutions.
Conclusions: The results of this study appeared that sterilization by the microwave irradiation produce
a significant effect on the dimensional stability of the heat–cured acrylic resin, while sterilization by
chemical solution produce no significant difference.

Microleakage of Repaired Amalgam


Aims: This invitro study designed to investigate the effect of bonding agent on amalgam repaired with either spherical or admixed alloy. Material and Methods: Cl I cavity preparations were made on the occlusal surface of hundred and twelve extracted human premolars. The teeth were randomly divided into two groups, 56 cavities filled with spherical amalgam and the other 56 cavities filled with admixed amalgam, after aging of restorations, buccal half of the previously placed restorations were removed and each group was divided into two subgroup according to the lining material used. The final number were eight groups of 14 teeth in each. All specimens were thermocycled for 500 times with 15 second dwell time. The samples were stained with 2% methylene blue, sectioned and evaluated for dye penetration. The data were analyzed by Fisher Freeman Halton test.Results: There was a significant differences in microleakage of bonded and non–bonded specimens, the use of bonding agent significantly increase the microleakage of repaired amalgam. Repairing amalgam with similar alloy type significantly reduce the microleakage.Conclusions: Within the limitation of this study, repairing amalgam with bonding agent is acceptable but significantly less microleakage can observed when amalgam repaired without bonding agents. malgam alloy can repaired with different types of alloy, but better marginal seal accomplished when the same types of alloy used for repair


Antiviral Effect of Ethanolic Extract of Salvadora Persica (Siwak) on Herpes Simplex Virus Infection.

Authors: Mahmoud YM Taha
Pages: 50-55

Aims: To investigate the effect of ethanolic extract of Salvadora Persica extract on HSV–1 infection
both in vitro and in vivo in the mouse model system. Materials and methods: Ethanolic extract of
Salvadora Persica was used at different concentrations. BHK cells that grown in Eagles medium were
used for virus isolation and titration using PFU/ml. The effects of different concentrations of Salvadora
Persica on viral growth in BHK cells as well as cytolytic activity of HSV–1 were evaluated at different
time post infection. The therapeutic efficacy of Salvadora Persica in vivo was studied in mice. Lesions
were scored and viral isolation from infected skin and ganglia was titrated on BHK cells. Results:
Salvadora Persica inhibited the replication of HSV–1 in BHK cells as well as the cytolytic activity of
cell free virus. Topical application of Salvadora Persica on the skin of mice infected with HSV–1
reduced the development of cutaneous lesions and the viral titers in the skin and ganglia were also
reduced. Conclusion: The results of this work may be beneficial for the treatment of recurrent oral
herpes infections.


Miswak; Antiviral --- HSV–1

Single Buccal Injection for Anesthesia of Upper First Molar


Aims: A clinical trial was carried out to assess the efficiency of a single buccal injection to achieve
anesthesia of the buccal aspect of the upper first molar instead of the traditional two injections. Materials
and Methods: The subjects included in the clinical assessment were those needing extraction of
an upper first molar of either side. For the purpose of comparison, the sample was randomly divided
into two main groups: Group I (control group) which included 100 subjects who were to receive two
buccal injections and a single palatal injection before extraction. While Group II (trial group) included
100 subjects who were to receive a single buccal injection and a single palatal injection before extraction.
The following data were recorded: Pain on needle insertion, pain on deposition of solution, onset
of surgical anesthesia and adequate surgical anesthesia. Results: The first criterion recorded was pain
on needle insertion where the results showed no significant difference between both groups. The
second criterion was pain on deposition of solution. Here the results also showed no significant difference
between both groups in this aspect. For onset of surgical anesthesia, no significant difference was
shown between both groups. In regard to pain grade experienced during surgery for both groups, the
results showed that grade A anesthesia was recorded in 95% of patients in group I , whereas in 93% of
patients in group II. Grade B anesthesia was recorded in 5% of patients in group I and in 7% of patients
in group II. Statistically speaking, no significant difference was disclosed in regard to pain assessed
during the extraction of the tooth between both groups. Conclusions: The achievement of successful
local anesthesia is a continual challenge in dentistry. Any suggested new approach for achieving adequate
anesthesia for either the maxilla or mandible as long as it is safe and effective can be recommended
for routine dental care.

Experience of Mothers about their Infants’ Teething in Mosul City


Aims: To evaluate mothers experience about their infants’ teething, which symptoms they have seen and attributed to teething and how they have acted to manage these symptoms. Material and Methods: In this study, A total of 200 mothers of children less than 18 months of age, who had at least one tooth and who came to the primary health care centers for vaccination of their children were asked to participate in this study. The first part of the questionnaires was to clarify the eruption time of the first primary tooth and in the other part the mothers were also asked about the symptoms they attributed to teething and the methods they used to relief the symptoms. Results: The mean eruption time of the first tooth of the infants was 6.9 ± 2 months, with a range of 4 – 18 months. All of the mothers reported that their children had suffered from at least one of the symptoms that were mentioned in the questionnaire. The prevalence of teething symptoms distributed according to the age groups demonstrated that fever, irritability, sleep disturbance and lose of appetite were significantly highest in (below 6) months age group, while diarrhea, dribbling, runny nose, vomiting, cough, diaper rash and smelly urine were significantly highest in (6 – 12) months age group. Conclusion: It is commonly thought that teething in infants can cause a variety of signs and symptoms. In this study all the mothers believed that teething is associated with the appearance of symptoms, some of which are minor and related to discomfort, while others are physical illness


Infants --- teething

An evaluation of the Film–Based and Digital Panoramic Radiographic Quality

Authors: Rand Shaker Al–Ani
Pages: 67-71

Aims: To compare the image quality of panoramic radiographs obtained with charge–coupled device
(CCD) and screen–film systems. Materials and methods: True Panoramic radiographs were taken in
26 patients each with both screen–film and CCD systems. The images were obtained with TRATO
2000, CE by VILLA SISTEMI MEDICALIS–ITALY with regular intensifying screen type
Kodak Lanex and 6 x 12 inch screen type film used for film–based projection, while Dimax3
digital system pan/ceph, PLANMECA, Helsinki, Finland with CCD X–ray image sensor (the
size of the panoramic sensor was 15 x 30 cm and the resolution of the panoramic image was around
230 dpi, used for digital projection. Both X–ray machines were operated at range of 70–80
kV and 10–12 mA, according to the patient age. Altogether, the digital images files were
displayed on 17 inch monitor, brightness and contrast were fixed and no enhancement was
made before the digital images files were saved. While the film–based images after processing
were viewed on the viewer box. Image quality was assessed by rating the visibility
of five anatomical landmarks commonly found on panoramic radiographs: The superior and
inferior cortex of the mandibular canal, the superior and inferior margin of the mental
foramen, the lower and anterior border of the maxillary sinus, the lower border of the
mandible, and the articular eminence. For each image, the given landmark was rated as good
(image of excellent diagnostic quality), acceptable (image of diagnostic quality but should
be improved), or unacceptable (image not of diagnostic quality). Each image was then given
an overall evaluation rating of good, acceptable, or unacceptable. Results: The data collected
from the evaluation of the digital and film–based images by the three examiners, were analyzed
by t–test. The image quality, as represented by each of the five anatomical landmarks,
and the overall rating for each system were expressed as the mean scores of the three
examiners. The difference between the film–based and the digital images systems was not statistically
significant (P>0.05). Conclusions: It was concluded that digital panoramic radiographs are equivalent
to film–based images for the five anatomical landmarks.


Digital --- film–based --- panoramic

Evaluation of The Effect of Immersion Periods in The Artificial Saliva on The Surface Roughness of Three Types of orthodontic Arch Wires

Authors: Zaid S Tawfek --- Khudair A Al–Jumaili
Pages: 72-78

Aims: To evaluate the effect of immersion periods in artificial saliva on the surface roughness of an arch wire. Materials and Methods: The roughness of three types of orthodontic arch wires: stainless steel (SS), titanium molybdenum alloy (TMA) and composite coated wire (CC) were first measured at dry condition then incubated in artificial saliva at 37 o C with saliva pH (7.25) for different immersion periods (1, 14 and 28 days). Then the surface roughness was measured by using Taylor Hobson Profi-lometer (Talysurf type 10). Results: There was a significant increase in surface roughness of the three types of wires during the first day of immersion but as the immersion periods increased, it showed a non significant difference in the roughness of SS and TMA. The roughness of CC however, increased. Conclusions: It was concluded that the surface roughness of SS and TMA wires increased during the first day of immersion, such increase is not significant after that, while in case of CC, as the immersion periods increase the surface roughness significantly increased.

The Frictional Coefficient Comparison Between Stainless Steel And Beta– Titanium Arch wires Ligatured to the Stainless Steel Bracket Via Different Ligatures

Authors: Anas M Al-Mukhtar --- Hussain A Obaidi
Pages: 79-82

Aims: To compare the frictional coefficients between the stainless steel and B–titanium arch wire liga-tured to the stainless steel bracket via different ligatures. Materials and Methods: The sample of the study included the stainless steel and β–Titanium arch wire groups, the wire group comprised of three subgroups, each wire subgroup ligatured to stainless steel brackets via different ligatures. The mea-surement of the frictional coefficient was performed using the simulated side arch fixed appliance at-tached to the tensile machine. The data were analyzed by using the descriptive and variance statistical tests at p≤ 0.05 significance level. Results: The results demonstrated that the stainless steel arch wire tied to the bracket via stainless steel ligature achieved significant lower frictional coefficient value when compared with other wire subgroups. Conclusions: The combination of the stainless steel; arch wire, bracket and ligature is more practical choice in sliding orthodontic treatments.

Dental caries prevalence among inter-mediate and secondary school students in Thamar–Yemen

Authors: Faraed D Salman
Pages: 83-89

Aims: To determine the prevalence of dental caries among intermediate and secondary school students 13–16 years old to determine the age and sex difference and to obtain data that can help in planning preventive dental health programs for school students in Yemen. Materials and Methods: A random sample of 512 intermediate school students,449 secondary school students were examined. Interme-diate school student sample was divided into 3 age groups namely 13,14,15 and secondary school stu-dent sample was divided into 3 age groups namely 16,17,18 years old. The WHO methodology (1997) was used to assess the individual tooth status. Results: The mean DMFT for the total sample was 5.2±0.13; which increased with the increasing of age from 4.54 to 4.84 to 6.47 for the age groups 13,14,15 years old respectively; without significant sex difference as total 5.44 for males and 5.14 for total females. Results of dental caries for the secondary school students showed that the mean DMFT for the total sample was 5.98± 0.14, which decreased with the increasing of age from 5.60 to 6.49 to 5.85 for the age groups 16,17,18 years old respectively, with peak value at 17 years old without signifi-cant sex difference, 5.74 for total males, 6.21 for total females. Conclusion: The mean DMFT for both intermediate, secondary schools increased with increasing age with statistical significant difference with no sex differences.

Natural fluoride Content of Drinking Water in Two District Areas in Iraq and Yemen (A comparative study).

Authors: May Gh Al–Ajrab --- Faraed D Salman
Pages: 90-103

Aims: To determine and compare the prevalence and severity of dental fluorosis in two district areas: Iraq and Yemen, in relation to age and sex for students aged 13–16 years old. Materials and methods: the study was conducted among 904 students of both countries. Five hundred and seventy two students from Iraq (Sinjar province): 334 males and 238 females. Three hundred and thirty two students: 173 males and 159 females, from Yemen (Thamar province); aged 13–16 years old were randomly selected from intermediate and secondary schools who had lived since birth in two different areas with concentration of fluoride in drinking water. Sinjar with high concentration (2.05–2.22 ppm), Thamar with moderate concentration (1.8–2.2 ppm) by the use of Dean index (1934) to assess dental fluorosis. Results: the study had shown that the prevalence of dental flourosis in Sinjar province was 52.1%, 63.53% within students and teeth respectively was much higher than Thamar province which was 16.99%, 30.23% within students and teeth respectively; ranging from questionable, very mild forms for all age groups, while for Thamar it was ranging from very mild to moderate with significant sex difference for individuals (females reported less prevalence than males) for both provinces for the first three degrees of flourosis at P<0.001, P< 0.05. The percent age of severity for Sinjar was much higher than Thamar province which increased significantly with increasing age at P<0.001, P<0.01,and P< 0.05. Also the distribution of severity of frequency was much higher in Sinjar than Thamar with highest percentage in upper and lower posterior teeth (75%, 72%) at P<0.001. The community flourosis index for Sinjar was 1.62 (moderate) while for Thamar province was 3.05 for these age groups (very marked). Conclusions: prevalence of dental flourosis increased infrequently with age in Sinjar while systematically in Thamar with sex difference (females reported less percentage than males).

Retrospective Assessment of the Success Rate of Single-Visit Root Canal Treatment: A Clinical and Radiographical Analysis

Authors: Ali M. Rashid
Pages: 104-109

Aim: The purpose of this study was to determine retrospectively, clinically and radiographically the suc-cess rate of single–visit root canal treatment and determine the possible factors that could affected there prognosis.Materials and Methods: nine–hundred and sixty–five single–visi1 cases, of which 322 present for re–examination appointment ranging from 6 months to 5 years from the day of treatment were considered. Clinical and radiographical data were used to form overall impression of the outcomes for each case at the time of re–examination. Available demographics and treatment information of these 322 cases were compiled for comparison. The number of treatment visits was not determined by a pre-treatment diagnosis or a re–assessment of the pulp status upon entry in to the tooth; therefore both vital and necrotic cases, as well as those with and without periradicular pathosis, Were included. Statistical analysis was carried out using Chi–square test and considered variations in failure rates based on gender, tooth type, position and arch. A t–test was used to evaluate data on age. Results: The overall success rate was 92.8%. No statistically significan1 differences were seen based on gender and arches. The data show almost younger ages more candidate for failure rate than older age group. Statistically, anterior teeth were more successful than posterior teeth. Conclusion: The success rate of single–visit root canal therapy was engorgement for this approach .Both gender and arches were not affecting the treatment outcome in this study, where as the treatment for older age and anterior teeth more successful than younger and posterior teeth respectively.

Construction of Nasal Prosthesis for a Patient with Rhino Cerebral Mucormycosis (A clinical Report).


Aim: To construct a nasal prosthesis for a patient with Rhino cerebral mucormycosis disease and of
near total Rhinectomy. Materials and method: a permanent soft lining material was adapted over
frame work of nose made from visible light cure denture base material, then cured, finished and
polished. Results the finished nose was retained by engaging undercut and by the use of eye glass.
Conclusion: A custom sculpted prosthesis combined with soft lining material gives a natural texture of
the nose was accomplished within 24 hour.

Gag Reflex Reduction in A Patient with Maxillofacial Prosthesis. ( A Clinical Report )

Authors: Balsam K. Fathi --- Nadira A Hatim
Pages: 114-119

Aim: the study was dedicated to demonstrate the importance of binding the old concepts of preventing
the gag reflex during the prosthodontic work together with the new advance in the concepts, techniques,
and materials in this scope. Materials and Methods: Silicone rubber base impression material (Oranwash
L, Zhermack, Italy) light, and heavy body was used in the study to take the impression by a new
technique (cheek bite technique) without the use of a tray, and on incremental basis, which showed
more comfort and better results. The prosthesis given to the patient took advantage of the neutral zone
principles, which whenever applied it gives better results, it was hollowed, in addition, the procedure
carried less stimulation to the gag reflex, and more assurance. Results: The obturator obtained by the
technique described was larger in size, lighter in weight, and more comfortable, and efficient in function
compared to the old one ,the entire procedure from the impression taking, to the delivery, and after, carried
less stimulation of the gag reflex, and gave better results. Conclusion: The advance in the prosthetic
materials, and techniques when combined with the available techniques, and information can give
better results.

The Effect of Flap Design on Wound Healing after Periapical Surgery: A Comparative Study.

Authors: Mohammad S. Suleiman
Pages: 120-127

Aims: To assess the clinical effect of different flap design that used in periapical surgery and their
relation to untoward postoperative sequel. Materials and methods: Forty five patients were included
in the present study, they were divided randomly into three groups, each comprised of (15) patients. In
the first group, apicectomy was done using intrasulcular triangular (2–sided) flap. Whereas, in the
second group, a submarginal (Luebke–Ochsenbein) scalloped 2–sided flap was used. While in the third
group, a new experimental (straight mucogingival) 2–sided flap was tested. Postoperative healing was
evaluated clinically in regard to oedema, alteration of soft tissue colour, recession of marginal gingiva,
extent of scarring, and closure of the wound site. Assessment was done at 2, 7, 15 and 30 days
postoperative intervals. Results: Comparison among the three study groups was performed. Statistical
analysis revealed significant differences in the results of experimental flap over the other two types in
regard to oedema, colour and wound closure with the superiority of the former on the latter flaps. Both
experimental and Luebke–Ochsenbein flaps showed significant differences from intrasulcular incision
in their effect on gingival recession. In contrast, scarring was less evident in intrasulcular flap followed
by experimental flap while in Luebke–Ochsenbein incision, this complication was significant.
Conclusion: This study; however, revealed that the experimental flap allows for rapid and recession
free healing following periapical surgery. In addition, inflammatory changes persist for longer time in
the intrasulcular and submarginal (Luebke–Ochsenbein) incision than in experemintal incision. So it
was concluded that the new flap design could provide an alternative.

Table of content: volume:8 issue:1