This case report shows the experimental treatment of a 85 year old female with advanced periimplantitis, the surgical augmentation, the clinical as well as the radiological follow-up until twelve months after surgery. the treatment of the advanced periimplantitis with a three-dimensional vertical defect around the implant consisted of a surgical bone augmentation technique supported by the Air-Flow Master® system (EMS, Nyon, Switzerland).
The aim of the study was to evaluate the efficacy of Parodontax® (GlaxoSmith-Kline, Bühl, Germany) on the signs gingival inflammation and the enzyme activity of matrix metalloproteinase-8 (aMMP-8) in the gingival crevicular fluid. After approval by the ethics commission, a total of 50 volunteers participated in the study; group 1 (n = 25, age: 43 ± 12 years) with moderate gingivitis (BOP +) and group 2 (n = 25, age: 29 ± 11 years) with clinically healthy gingival conditions (BOP -). After obtaining anamnestic data, the dental examination included assessment of oral hygiene (Quigley & Hein 1962), gingival inflammation (Saxer & Mühlemann 1975), probing pocket depth and clinical attachment level. Gingival crevicular fluid was collected from both groups. A quantitative assessment of aMMP-8 in the gingival crevicular fluid samples was performed (DentoAnalyzer, Dentognostics GmbH, Jena, Germany). Study participants were instructed to use only Parodontax®. After three weeks, all parameters were measured again. The aMMP-8 values of group 1 were significantly reduced after the use of Parodontax® toothpaste and mouthwash (p < 0.001; baseline median 41.25 ± 38.16 ng/ml, final post-treatment median 7.73 ± 7.58 ng/ml aMMP-8 eluate; group 2: baseline median 3.75 ± 3.16 ng/ml, final post-treatment median 3.73 ± 1.54 ng/ml aMMP-8 eluate). Gingival inflammation and plaque accumulation were reduced. It was shown that Parodontax® was effective in reducing the enzymatic activity of inflammation.
Zirconia as a framework material is well established in fixed prosthodontics. However, for its application for removable dentures little experience exists. Zirkonzahn® has developed a copy-milling unit, that is a manually operated machine for the manufacture not only of frameworks but also of complete removable dentures. The aim of this case report is to show the step-by-step clinical and technical fabrication of a zirconia bar on implants and of a corresponding zirconia complete denture. The advantages and disadvantages of the system are presented and problems are critically discussed.
Background: At the Clinic for Radiation Oncology at the Zurich University Hospital (UniversitätsSpital Zürich [USZ]), head-and-neck tumor (HNT) patients have been treated with intensity-modulated radiotherapy (IMRT) since 01/2002 (n 〉 800). This method causes less damage to normal tissues adjacent to the tumor, and thus it was possible in the head/neck region to markedly reduce the rate of osteoradionecrosis (ORN), in addition to reducing the rate of severe xerostomia. Based on these results, risk-adapted dental care (RaDC) was adopted by our clinic as the standard mode of pre-IMRT dental treatment. The guidelines as formulated by Grötz et al. were respected. ORN prophylaxis is one of the most important goals of pre-radiotherapy dental care, and the ORN rate is a measurable parameter for the efficacy of dental care, given a certain radiation technique. The aim of the present study was therefore to evaluate the efficacy of RaDC as reflected by the ORN rate of our IMRT patients.
Materials and methods: IN August 2006, RaDC was clinically implemented and has been used for all HNT patients prior to IMRT since then. Before that (01/2002-07/2006), dental restorations were performed according to the usual procedure.
Results: The rate of grade-2 ORN was similar in the conventionally treated and RaDC groups (2% and 1%, resp.); grade-3 ORN had not occurred by the time the analysis was conducted. As expected, fewer extractions were performed in the RaDC cohort (no extractions in 47% of the RaDC/IMRT cohort vs. 27% in the IMRT cohort receiving conventional dental care).
Conclusion: After considerably less invasive dental treatment, no higher-grade ORN occurred and no ORN-related jaw resections were required. Based on the present data, risk-adapted minimally invasive dental care is recommended before IMRT.
Background: The antibacterial photodynamic therapy (PDT) has been effective in the periodontal therapy. The laser light application reported in the literature so far is the subgingival placement of a light fibre.
Objectives: To study the effect of PDT with a transgingival laser application.
Materials and methods: In 19 patients with untreated periodontitis 1 test and 1 control site were selected. Both pockets were treated by scaling, root planing. the Test site received additional PDT (LASOTRONIC MED 701 by ORCOS MEDICAL, Switzerland) at baseline, after 2 and 6 months. The control sites were rinsed with ringer solution. Clinical parameters (ST, BOP, CAL) and bacterial monitoring (PADO, IAI, Switzerland) at baseline, 2 and 6 months were recorded.
Results: Mean pocket reduction was after 6 months 2.1 mm (+/-1.4) in the test group, 1.5 mm (+/-1.6) in the control group significantly different. The 95% confidence interval for the difference of the mean reductions of the test and control group after 6 months is (1.5, 3). Mean CAL gain after 6 months was 1.5 mm (+/-1.3) in the test, 0.9 mm (+/-1.7) in the control group. T. denticola showed lower number after 2 and 6 months in the test versus the control. The total bacterial load (TBL) showed significantly better reduction in the test group at 6 months.
Conclusions: The transgingival application of PDT with the MED 701 showed clinical and bacteriological effects which are comparable to those reported in the literature with the subgingival method. The transgingival method is convenient, harmless and easy to perform.
The first part of this three-part review on the relevance of laboratory testing of composites and adhesives deals with approval requirements for composite materials. We compare the in vivo and in vitro literature data and discuss the relevance of in vitro analyses. The standardized ISO protocols are presented, with a focus on the evaluation of physical parameters. These tests all have a standardized protocol that describes the entire test set-up. The tests analyse flexural strength, depth of cure, susceptibility to ambient light, color stability, water sorption and solubility, and radiopacity. Some tests have a clinical correlation. A high flexural strength, for instance, decreases the risk of fractures of the marginal ridge in posterior restorations and incisal edge build-ups of restored anterior teeth. Other tests do not have a clinical correlation or the threshold values are too low, which results in an approval of materials that show inferior clinical properties (e.g., radiopacity). It is advantageous to know the test set-ups and the ideal threshold values to correctly interpret the material data. Overall, however, laboratory assessment alone cannot ensure the clinical success of a product.
Regardless of the success of preventive measures the replace¬ment of missing teeth in young patients with caries-free dentitions is a daily challenge for the clinician. The decision-making process concerning the different treatment options is difficult, based on several equivalent solutions. Thereby the significance of minimal invasive approaches is steadily increasing. In indicated cases, resin-bonded fixed partial dentures which were introduced in the last century still represent a well documented and minimally invasive procedure, even in the era of dental implants. In this article, clinical aspects of a conventional, metal-based resin-bonded fixed partial dentures are discussed according to the current literature and the clinical steps are presented in a clinical case.
This survey aimed to evaluate the common practice of regenerative periodontal surgery with special regard to the use of enamel matrix derivatives (EMD, Emdogain® ) by board-certified specialists in periodontology and non-certified, but active members of the Swiss Society of Periodontology (SSP). A cross-sectional postal survey of 533 dentists, representing all members of the SSP practising in Switzerland, was conducted. The questionnaire consisted of three sections, assessing: 1) general personal information regarding the practice setting and education, 2) general questions regarding periodontal surgery practices and 3) specific questions regarding the use of EMD. The information obtained was compared and differences between specialists and non-specialists were calculated. P-values smaller than 5% were considered significant. Sixty-nine percent of the specialists answered the questionnaire, compared to only 37.4% of the non-specialists (overall: 42.4%). In general, specialists performed surgeries more frequently, and presented a significantly higher percentage of EMD users than the non-specialists. The application guidelines were followed in general. Some differences were observed in application and selection criteria. The subjective perception of clinical success varied greatly among clinicians. Residual pockets were reported to be present in approximately one third of the defects after therapy. In conclusion, this survey revealed that EMD was used on a regular basis by dentists performing periodontal therapy. In addition, the answers by both groups generally corresponded well with the current available literature.
In the third part of this review of laboratory testing, methods of testing adhesive systems are evaluated. Test set-ups that are used to analyze the restorative material in combination with the adhesive system are presented. Currently, there is no standardized protocol available for the evaluation of adhesives. This complicates any direct comparisons of values between different testing institutes. Therefore, the statistically evaluated ranking of the different adhesives is more important than mean values. Depending on the testing institute, a correlation between bond strength measurements and clinical outcomes may exist. Qualitative analysis of adhesive/tooth interaction can help explain the functioning of a system, but the depth of penetration of the adhesive cannot predict bond strength. Indirect bond measurements or analyses of the interactions of adhesive and composite materials, such as dye penetration or marginal analysis, do not correlate or correlate only partially with clinical findings. Adhesive systems should be tested in vitro and compared to a well-known standard adhesive before they are used in the clinic. Water storage of specimens for several months before testing increases the predictability of the bonding performance of the tested adhesive.
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