Journal of Dental School
Volume:29 Issue: 5, 2012

One of the problems involved in the restoration of extensive cavities is loss of the fracture resistance of the remaining tooth structure to withstand masticatory forces. But possible reinforcement of remaining tooth structure has been increased by the use of adhesive restorative materials. Tooth reinforcement may be affected by the different physical properties of direct and indirect composite resin restorations.So, theaim of this study was tocompare direct and indirect composite resin restorations effect on the fracture resistance of maxillary premolars with mesio-occluso distal (MOD) cavities. In this experimental (in vitro) study, 24 human maxillary premolars free of any caries, restoration or crack, which had been extracted in a 6 month period, were selected and MOD cavities with the bucco-lingual extension equal to two third of intercuspal distance were prepared on them all. The teeth were divided randomly in 3 groups including A (8 teeth & direct restoration group), B (8 teeth & indirect restoration group) and C (8 teeth &preparation without restoration group) and were undergone fracture test with universal testing machine.Variance and Tukey tests were used for analysis of results; the level of significance was set at 0.05. The mean fracture resistance was1314.75 ± 332.26, 1192.25 ± 352.45 and 382.45 ± 142.51 for direct restoration, indirect restoration and preparation withoutrestoration groups,respectively. There was no significant difference between A & B groups (P=0.60), whereas the differences were significant between A&C groups (P=0.00) and also B&C groups (P=0.00). According to the present study, both direct and indirect composite restorations cause increase in the fracture resistance of teeth and so can have an important role in extensive cavities.

Inadequate torque application during screw tightening in dental Implants is one of the responsible factors of screw loosening and fracture and others technical complications. Mechanical torque limiting Devices (MTLDs) are necessary tools to control a peak torque and achieving a target values. Accuracy of these devices, particularly in friction–style type is reported with high variability. Due to vague and controversial aspect of steam sterilization on the accuracy of these devices their preparation steps (dismantling of the components, lubrication, broken position of the handle) before sterilization, this study aimed to evaluate the effect of steam sterilization without preparation steps on the accuracy of friction-style MTLDs. Fifteen new friction-style MTLDs from three different manufacturers, five for each group, were purchased. All peak torque measurement, considering their target torque, were measured ten times consecutively before and after 100 cycles of steam sterilization using Tohnichi torque gauge. For steam sterilization procedure, 100 cycles of autoclave without preparation steps before each cycle were performed. Comparison of error values and range of difference between the measured torque value and the target torque values before/after sterilization were performed with a One- way Repeated- measures ANOVA to significant level of P<0.05, considering type of devices as a between subject comparison. For pair wise comparison Bonferroni post hoc test was used. After steam sterilization without preparation steps, difference between target torque and peak values increased in all of the 3 groups studied (P<0.05). Peak torque values showed more than 10% difference from the target torque (suitable clinically accepted torque) in some measurements. Range of error was -1 to 4 Ncm in Dr Idhe group, -1 to 3 Ncm in AstraTech group and -3.5 to 1 Ncm in Biohorizon group. Within the limitation of this study maximum error values were 12% in Astra Tech MTLDs, 13.3% in Dr Idhe MTLDs and 11.7% in Biohorizon MTLDs. Greater variability was seen for Biohorizon and Dr Idhe groups than for Astra Tech group. CLINICAL IMPLICATION: Sterilization without preparation steps affects the accuracy of friction-style mechanical torque limiting devices. Combined effects of sterilization and aging needs to be determined.

The new Path File rotary instruments for mechanical pre flaring were recently introduced and it has been claimed to possess numerous merits in the canal preparations. The present study compared the fracture rates during mechanical pre flaring by using manual (k-files) and Path File in the Pro Taper rotary system. This experimental in vitro study was done on 100 acrylic blocks with the similar curve and working length. The root canals were randomly received mechanical pre flaring using Path File and manual k-files in the blocks. The number of the fractured files was determined when S1, S2, F1, F2 and F3 files would maintained the working length during the repeated uses. The results of both groups were compared by Kaplan-Meier (Log Rank) statistical test. In the manual system, no case of fractures was seen in S1, S2 and F1 files, however, 2 files fractured after 7th use in F2 and 3 files fractured after 5th use in the F3 files. No Path file was fractured in S1 too. But, in S2, 1 file was fractured after 6th uses, 2 files fractured in F1 after 6th uses, 2 files fractured in F2 after 7th uses and 4 files fractured in F3 after 5th uses. No significant differences were observed between two systems regarding the number of fractured files (p>0.14). According to the results, Path File rotary system does not show better results during mechanical pre flaring when compared to manual instruments, although no significant differences were noted between two systems.

Sometimes, sensory disorders occur without any organic etiology which this entity could make problem in diagnose and treatment. Therefore, the aim of this present study was to evaluate the psychiatric treatment effects on unexplained oral and maxillofacial sensory disorders.

In this experimental study, 20 patients with diagnosis of unexplained oral and maxillofacial sensory disorders whit out any organic origin were examined. The severity of symptoms was documented based on a 0-5 numerical scale by patients. The patients were referred to the psychologist for their problems. All subjects were controlled per two weeks for about 6 months and in each follow up their severity of symptoms were detected. The mean of severity of sensory disorders was compare before and after treatment by t- test.

In this study, there was a positive correlation between psychiatric treatment and increasing in severity of patient’s symptoms. The mean of severity of sensory disorders before treatment was 4 unit and after that reached to 1.1 unit. The rate of therapeutic effect was higher in men than women. Also, the rate of response to the treatment in patients with involutional melancholia was better than patients with other psychological disorders.

The results of this study showed, that severity of unexplained oral and maxillofacial sensory disorders decreased after psychiatric treatments.

Good marginal adaptation is a prerequisite for a successful crown restoration while the incidence of microleakage, caries, damage to the base teeth and periodontal diseases is facilitated when this criteria is not achieved. Therefore, the present study determined the marginal gap in the porcelain crowns compared to indirect composite restorations of GC Gradia and Signum. In this invitro experimental study, 30 impressions were taken in the similar conditions and randomly assigned to receive porcelain crowns (Noritake super porcelain Ex-3) or indirect composite crowns of GC Gradia and Signum when no fluid and porosity were noted on them. The crowns were fitted on the master metal die and assessed by the stereomicroscope after complete sitting and finishing line preparation. The assessments were carried out on 8 points 1mm from the finishing line (buccal, lingual, mesial, distal, mesiobuccal, distobucaal, mesiolingual and distolingual). Then, 8 jigs were fabricated and total 240 readings were made. The values were converted to micron and the statistical comparisons were made using nonparametric Kruskal-wallis and Mann-whitney U tests. Marginal gap of porcelain crowns was29/08 ± 9/38μm and 84/53± 15/47μm on the lingual and disto lingual points andtheGC gradia indirect composite, was 43.63±13.40μm and 74.53±28.03μm on the distal and distolingual points as well as 39.08±17.68μm and 95.44±30.66μm on the distal and mesiolingual aspects of the Signum indirect composites respectively.No significant differences were noted between the three crowns brands on the mesial, distal, mesiobuccal, distobuccal, and mesiolingual aspects.only 3 points(buccal, lingual and disto lingual) had significant differences. Regarding clinically acceptable values of marginal gaps mentioned in the literature,porcelain jacket crowns and indirect composite crowns possesses the necessary criteria of marginal gap and can be successfully used for crown restorations.

Different cements are used to attach orthodontic bands which require special considerations in terms of technique sensitivity during setting reaction, water solubility and decomposition over time each of which may result in attachment failure, decalcification and caries in long term. This study was designed to assess the weight changes of different zinc phosphate and polycarboxylate cements used in orthodontics. An experimental study was designed to compare two available conventional cements (zinc phosphate and polycarboxilate) in the department of dental materials, SBMU School of Dentistry, Tehran, Iran. The cements were categorized according to ADA 8 index and the data were analyzed with electronic balance. Weight variations were recorded after 6 weeks floating the samples in water and data were subjected to analysis using Repeated Measured ANOVA test. There was the maximum mean value of weight loss for Aria Dent zinc phosphate cement and the least with Adhezor zinc phosphate within the period of study. Regarding plycarboxylate cement, Aria Dent polycarboxylate displayed the greater weight variation over the time compared to other conventional cement and the minimum value of weight loss was for Durelon cement. It is concluded that Aria Dent zinc phosphate and polycarboxylate cement display greater weight variations over time compared to other conventional cements.

Low Level Laser Therapy is used in many aspects in medicine and dentistry, such as treatment of bone lesions. The purpose of this study was to evaluate the effect of low level laser (GaAlAs) combined with the application of DFDBA in bone healing of rabbit tibia. The experimental study was done on 12 male albino rabbits with an approximate weight of 1.5 kg and about 6 months of age. In order to perform the surgery, animals were anesthetized with intravenous injection of Ketamin 10% and Xylazine 2%. An artificial lesion was created using implant drills (height of 4 mm and diameter of 2.8 mm) in tibia bone and was filled with DFDBA. Then, the lesions were irradiated using laser with distinct protocol (10 days irradiation, 14 days rest, 10 days irradiation, 14 days rest). Type of the laser was GaAlAr with wavelength of 808 nm, energy of 6 J/cm2 and in continuous mode. No irradiation was done in the control group. After 48 days, the animals were sacrificed and sections from tibia was made and the specimens were underwent histological assessments. Wilcoxon signed rank test was performed for evaluating the data. In histological assessment, laser group showed significantly more osteogenesis and angiogenesis (p<0.05). The findings of the present study show that GaAlAs irradiation together with the application of DFDBA led to improved healing, more angiogenesis, and osteogenesis in bone lesions of rabbit.

Factors affecting the retention of fixed prosthesis to natural abutments are well understood. In contrast, little is known concerning factors influencing the retention of fixed prostheses cemented to implant abutments. The purpose of this study was to investigate the effect that varying screw access channel filling materials and methods has on the retention of casting cemented to implant abutment A 15 degree preangeled abutment (Noble biocare Replace) was placed in implant analogue. Ten crowns were constructed that incorporated an attachment to allow removal. The screw access channels were either fully or partially filled with Gutta perka, Composit or silicone. Crowns were cemented to the abutment with TemoBond. The tensile force required to separate the cemented crowns from the abutment was measured using an Instron universal load testing machine. The mean peak removal force was significantly higher with partially filled access hole compared with fully filled. About the material filling the screw access hole, the mean peak removal force was highest with Composit and that was greater than Gutta perka and silicone respectively. The method and materials selected to fill the screw access channel of an implant abutment can be a significant factor affecting retention of a cemented restoration.

The most complex type of evaluation is teacher assessment since its measures have low validity & accuracy. To solve the mentioned problem, using a multidimensional approach is suggested. In Shahid Beheshti School of Dentistry, faculty evaluation is performed through 5 sources: undergraduate students, postgraduate students, department chair, education vice chancellor and dean of the school. The present study has been launched to determine the correlation between the students’ & managers’ ratings for faculty evaluation in academic year of 2010-2011.

In this cross sectional study, the questionnaires for faculty evaluation were delivered to the above mentioned 5 groups. Scores of each faculty member were calculated & Pearson coefficient of correlation was used to assess the correlation between the scores of five groups. In order to determine the effect of each group on the final score of teacher assessment, variance component ratio was calculated. Data were analyzed through SPSS software 11.5.

The scores allocated to the faculty members by dean of the school showed a significant positive correlation with the education vice chancellor scores (r=0.612). Correlations between the other groups were not statistically significant. Variance component ratio analysis showed that given the score weights were similar in all groups, postgraduate students had the maximum effect (50.89%) & education vice chancellor had the minimum effect (1.11%) on the variance of faculty evaluation scores.

The results of this study showed that among the five evaluating groups, just the opinions of education vice chancellor & dean of the school about faculty members have a significant positive correlation.

Ulcer and pain have been the most complications arised after periodontal surgery. The purpose of this study was to evaluate the healing and analgesic effect of Phenytoin in donor site of free gingival grafts. This study is a randomized clinical trial with 10 patients received free gingival graft and divided in 2 groups. The wound size measured with digimatic caliper. Donor sites rubbed in case group with Phenytoin and with placebo in control group. The wound size measured in 14th and 28th days and evaluated in comparision with baseline. Also, the pain level measured via VAS. Statistical analysis was performed using T pair test and wilcoxaon signed ranks. Statistical analysis showed that case group had better healing due to standard diviation in both appointments (α=0.1, p=0.078, and α=0.05, p=0.049, respectively). Pain Score was lower in patients treated with phenytoin (p=0.18) Phenytoin is effective in healing of donor site and reduce pain.

The orthodontic force-induced tissue strain produces local alterations in cellular and extracellular matrix reorganization, leading to the transformation and differentiation of cells. The present study was designed to investigate the influence of mechanical force on the CD90 expression of human mesenchymal stem cells (endometrial stem cells and dental pulp stem cells). The mesenchymal stem cells from passage 3-5 were seeded onto silicone membrane and cultured in medium with or without static mechanical stimulation (equiaxial and uniaxial strains). After 2 weeks, cultured cells were analyzed for expression of CD90. After 14 days in culture, immunfluorescence staining of cultured MSC demonstrated that mechanical stimulation of MSCs compared with control group, resulted in decreased CD90 expression. The decrease of CD90 expression in mechanically stimulated cultures compared to unstimulated control cultures suggests the possibility of differentiation of stem cells to other cells.

Temporomandibular Joint disorders are relatively frequent in different societies. The purpose of the present study was to determine abnormal Temporomandibular Joint radiographic findings in patients referred to Dental School, Shahid Beheshti University.

This descriptive cross-sectional study was done on 400 patients with no marked symptoms of temporomandibular joint disorders who met criteria of the study. Mean age of patient was 38.38. The data was collected by taking patients history, clinical evaluation while the panoramic radiographies were taken in standard conditions viewing by means of black-colored sheets. for statistical evaluation data was analyzed by chi- square and exact fisher tests.

Flattening was the most observed abnormal finding with 16.3% incidence. Erosion, condylar hyperplasia, concavity, Bifid condyle,condylar hypoplasia and sclerosis respected were the most common abnormal findings in this study. There were no significant differences in the incidence of abnormal findings regarding the patient’s gender, dental status and occlusion, but the prevalence of abnormal radiographic findings was significantly uprising as the age of the patients increased (P<0.002).

The results demonstrated the incidence of abnormal radiographic findings in 34.4% of the patients referring to the studied center which shows a relatively high prevalence.

Bone tissue engineering is an alternative strategy to generate bone utilizing a combination of biomaterials and cells. Bioactive porous three-dimensional scaffolds play important role in promotion of cellular proliferation and differentiation in tissue regeneration. In this study, in order to preparing of bone tissue engineering scaffold with good biocompatibility,bioactivity and physicochemical properties; we constructed porous three-dimensional chitosan-gelatin/hydroxyapatite and chitosan-gelatin/β-TCP composite scaffolds containing different amounts (0, 10, and 20wt.%) of gelatin through freeze-drying method. A novel bioactive ceramic/chitosan-gelatin network (HA- β-TCP /CS-Gel) was prepared as a three-dimensional biomimetic scaffold by freeze-drying method. Composite scaffolds of chitosan (CS)–gelatin (CG) with Hydroxyapatite and β-TCP were prepared by freez-drying of chitosan and gelatin(0%-10%-20%)- HA and β-TCP. The prepared Chitosan-gelatin/ceramic composite scaffolds were characterized using SEM and FTIR studies. The effect of gelatin and β-TCP in the scaffold matrix were evaluated in terms of scaffold properties.. In addition swelling ratio, porosity measurement of the composite scaffolds were studied. Our SEM results showed macroporous internal morphology in the scaffold with pore size ranging from 96to 206μm. Swelling behavior of the interconnected network showed the increasing of porosity with rising gelatin. The porosity decreased with increasing concentration of gelatin from 10% to 20%. Also due to the higher solubility rate of β-TCP, the porosity, pore size and swelling rate with the addition of β-TCP increased. FTIR studies showed the strong interaction between ceramic and chitosan-gelatin network. The results indicated that Chitosan-gel- HA scaffolds, fully interconnected with high porosity structure, thoroughly open pores and tailored pore size which prepared by freez-drying method is very similsr to bone structure, therefore it is suitable scaffold for bone tissue engineering.

Dental plaque is recognized as the main etiologic factor in gingival diseases. There fore, prevention and control of plaque aggregation on various dental surface display a very significant role in prophylaxis and treatment of both gingivitis and periodontitis. However mechanical removing of the plaque is the primary method for dental and oral hygiene, It can not be carried out perfectly even by precision patient. To resolve the problem, it is recommended to add chemical control to mechanical method. In respect to the importance of chemical control, this study purposes to evaluate synergic effect and compare effect of chlorhexidine, NaF mouth washes, a type of chemical method, on plaque control. The studied group consist of 15 dentistry students. After a thorough professional prophylaxis including interdental cleaning. 15 subjects started to rinse according to 4 different regiments: regimen CH-NaF: chlorhexidine Immediately followed by Sodium fluoride in the morning and in the evening; regimen NaF-CH: Sodium Fluoride immediately followed by Chlorhexidine in the morning and in the evening; regimen CH: chlorhexidine in the morning and in the evening; regimen NaF: Sodium Fluoride in the morning and in the evening. No further oral hygiene measures were allowed for the next 5 day. After 5day, the subject were scored for BOP, PI and PCR, afther of days` washout period of 4 days. Following this procedure, all subjects went through all 4 regiments. Our observation revealed no bleeding due to probing in all who used four rinsing regimes. The rate of plaque index varied according to the type and manner of the mouthwash applied, so that minimal plaque index was seen in combining chlorhexidine / Sodium Fluoride regimen. In addition, the mean plaque control record percent different in accordance to the type and manner of the mouthwash applied, so that the lowest mean was illustrated in the regimen combining chlorhexidine / Sodium Fluoride mouthwashes. The observation showed no bleeding on probing in subjects who applied four regimens. The best outcomes of plaque index and plaque control record were obtained with use of chlorhexidine-sodium fluoride mouth washes.

Forca perforation is one of the unexpected and unwanted accidents while root canal procedures which affects the long term prognosis of the therapy. Different material such as ProRoot MTA and MTA has been suggested to repair these perforations; however, the high price of these material has been troublesome for the patients and made the researchers to look for more suitable substitutions. Considering that Root MTA in comparison with other material is more accessible and suitable in price, the present study has been conducted to compare the bacterial microleakage of these three material (Root MTA, ProRoot MTA, Portland cement) to repair forca perforations. In this experimental invitro study, 60 extracted molars were divided into three experimental groups of Root MTA, ProRoot MTA and Portland cement (18 teeth in each group). There were also two groups of positive and negative in the study (3 teeth in each). Following access cavity preparation, cleaning and shaping was done. The crowns and the roots of the teeth were cut and the roots were filled. Then a perforation with the diameter of 1mm in the central part of the pulp chamber of each teeth was made. After repairing the perforations with the three material under study, the teeth were exposed to stafillococus epidermis bacteria and the degree of microleakage in each teeth was evaluated at the end of the first and the fifth week with the use of Cochrane, exact fischer and Chi-squre tests. The microleakage in ProRoot MTA group was: 8. 27, in Root MTA group was: 8. 27 and in the group of Portland cement was: 3. 33. according to statistical tests there were no significant difference amonge these three groups from the point of microleakage and the time of itُs occurrence. Considering the lack of any significant difference among the three groups under this study, provided that other characteristics of Root MTA and Portland cement are proven, these two are capable to act as substitutions for ProRoot MTA.

Replacement of a fractured metal-ceramic restoration is not possible in some cases.combination of different surface treatments and repair systems have been recommended for this purpose. The present study assessed the shear bond strength of three intra-oral metal-ceramic repair systems. In this in vitro study, 30 cylindrical metal specimens and 30 porcelain specimens were fabricated. The specimens were embedded in a ring, after surface treatment, the specimens received one of the following repair systems including Ultradent, Ivoclar Vivadent and Clearfil Multi-Purpose according to the manufacturers’ instructions. The specimens were stored in incubator then thermal cycled. The shear bond strength of the specimens and failure types was determined. The data were analyzed. On porcelain substrate, the mean and standard deviation of shear bond strength using Ultradent, Clearfil and Ivoclar Vivadent repair systems were 12.16 (±4.59), 10.19 (±4.18) and 12.68 (±4.89) while the rates were 14.32 (±3.15), 24.66 (±3.25) and 13.32 (±3.83) in the metal substrate. The bond strength of Clearfil system was significantly higher than others in the metal substrate (both: p<0.0001) while no other significant differences was noted in the paired comparisons. all metal specimens showed adhesive failures while the porcelain specimens demonstrated more cohesive failures. Although, replacement of the fractured metal-ceramic restorations is the ideal treatment modality, in the porcelain substrate all repair systems can be used. Clearfil repair system was associated with higher bond strength in the metal substrate.

MTA is used frequently in dentistry. Root MTA is produced in Iran recently.This in vitro study assessed the shear bond strength of Root MTA using etch and rinse and self etch bonding systems. In this in vitro study, 20 acrylic blocks with a central hole (6X 2mm) were prepared and filled with the Root MTA. Bonding systems of Single Bond (etch and rinse) and Clearfil SE Bond Bond (self etch) were applied on the Root MTA. Z100 composite tubes (2X2mm) were bonded to prepared surfaces. The shear bond strength was estimated by Universal testing machine in MPa. The data were subjected to t-test for statistical analysis. Mean shear bond strength of Root MTA to composite were 4.71±1.77 and 4.79±1.88 MPa using Single Bond and Clearfil SE Bond systems respectively. The difference between tow materials was not statistically significant. As suggested by the result of this research, the shear bond strength of Z100 composite to Root MTA were comparable using etch and rinse and self etch bonding systems.

Impression making is considered as an important step in the fixed prosthodontics.the different impression material and techniques have been supposed to be important in the dimensional changes of dies. Furthermore, the results of different studies in this regard are contradictory. The present study compared the results of two impression making techniques of putty-wash including two-step with space and double -wash using LIGHT and SUPER LIGHT viscosity.

In this experimentalinvitro study on the laboratory model, 10 impressions were made using two-step putty-wash technique with space and 10 impressions were made using double-wash techniqueby means of LIGHT and SUPER LIGHT viscosity. The impressions were poured using Velmix gypsum after 30 minutes. The height and diameter of the dies without undercut and the distance between two dies were measured 6 times while the variables were measured 3 times in the gypsum models by a blind operator using profile projector with an accuracy of micron. The mean values were calculated and the dimensions of the gypsum laboratory models were statistically analyzed by t- test.

The die height was decreased using both techniques of two-step with space and double-wash technique with LIGHT and SUPER LIGHT viscosity. The decrease was more pronounced in the double-wash technique by LIGHT and SUPER LIGHT viscosity. However, no significant differences were found between both techniques (P>0.05). Die diameter without undercut was significantly decreased in the double-wash technique by LIGHT and SUPER LIGHT viscosity (P<0.0001) while it was increased in the two-step technique with spaces. Slight distances were observed between two dies in the two-step impression technique with space. However, the distance between dies were increased using double-wash technique by LIGHT and SUPER LIGHT viscosity with significant differences (P<0.0001).

The die diameter was decreased in the impression technique of double-wash using LIGHT and SUPER LIGHT viscosity while the distance between base teeth have been increased in this technique. Therefore, the technique is not accurate and needs more assessments.

Barrier membranes have been extensively used for bone regeneration. However their effectiveness is still under investigation. This review was designed to answer the following question: "Do barrier membranes affect the successfulness of bone graft/ bone substitute materials?" Published articles were collected through hand and electronic searching in MEDLINE, EMBASE and CENTRAL databases. Controlled animal and human studies which had evaluated efficacy of membranes in defects other than periodontal lesion, extraction socket preservation and maxillary sinus graft, and had more than 4 weeks follow-up period were considered. Articles which had assessed membrane effect on oseointegration of implants, or had used osteoinductive materials in the bony defect were excluded. Meta-analysis was performed in the following groups: vertical bone augmentation, horizontal bone augmentation and eventful healing. Due to different outcome measurement, analysis was not done for horizontal bone augmentation. A total of 34 studies were selected. Meta-analysis of studies for vertical bone augmentation revealed that membranes may increase the amount of augmented bone (mean difference= 0.32 mm; P=0.006). No statistically significant differences were observed among groups in case of eventful healing both in human (odds ratio= 5.67; P=0.32) and animal studies (odds ratio= 3.35; P=0.12). Available evidence suggested that membranes might be useful for vertical bone augmentation. There was not strong evidence that membranes have an adverse effect on the healing process of the wound. More randomized clinical trials are necessary for applicable results.

Papillon-Lefèvre syndrome is a rare autosomal recessive genetic disorder characterized by palmar-plantar hyperkeratosis, with rapidly progressive periodontitis and premature loss of both deciduous and permanent teeth. This article presents the reconstruction of jaws of a patient with Papillon-Lefèvre syndrome with Iliac bone graft. Case Report: Interpositional graft with Lefort I surgery in maxilla and Onlay bone graft in mandible in a 20-year-old female patient with Papillon-Lefèvre syndrome was done. In our follow-up the bone grafts is clinically stable and no pain or infection was found. The patient continues to be seen at regular follow-up visits. Lefort I procedure and interpositional bone graft for reconstruction of maxillary in Papillon-Lefevre syndrome, make better profile in patients. We not only successfully treated our patient functionally and esthetically in first stage of treatment plane by bone grafting, but also provided psychological benefits to the patient.