Schweizer Monatsschrift fur Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia最新文献

Traumatic bone cysts, also referred to as simple bone cysts, solitary bone cysts and haemorrhagic bone cysts, are intraosseous pseudocysts and are categorized by the WHO (2005) as benign, bone-related lesions. Most often young patients under the age of twenty are affected. Symptoms are uncommon and normally the lesion is found in routine radiographic examinations in the mandible. The etiology is still unknown and it has been discussed that trauma, benign tumours or abnormal bone growth might be the cause. Surgical treatment is recommended and recurrence is rare. Histologic features of pseudocysts are a lack of lining epithelium and often an empty bone cavity can be found. The following case report presents a traumatic cyst in the mandible of a 14-year old female patient. Clinical, radiological and histopathological characteristics of this entity will be discussed as well as therapy and follow-up.

Five to ten percent of all hospitalized patients are treated in intensive care units. The risk of nosocomial infections is inherent in the latter, especially in cases of intubation. In this context, impaired oral hygiene may play a pivotal role. Therefore, the purpose of this survey among representative Swiss intensive care units was to assess the standards and measures taken in this patient collective with reduced oral hygiene. To this end, a questionnaire was sent to 25 institutions which represented all A- and University hospitals in Switzerland as well as all accredited intensive care units in the canton of Zurich according to the register of the Swiss Society of Intensive Medicine. Intensive care units from pediatric departments were excluded. Twenty-one questionnaires were received and evaluated (84%). Only one quarter of all respondents reported having protocols available for preventing ventilation-associated pneumonia (VAP). Systemic antibiotic regimens were never performed. Ninety percent reported cleaning the patients' teeth mechanically with a toothbrush. Sixty-seven percent used chlorhexidine as a disinfectant (81% in liquid form). Seventy-five percent of the responding hospitals performed routine oral cleaning procedures three times a day (90% immediately after intubation). In summary, oral prophylaxis was neither standardized nor consistently implemented in the evaluated Swiss intensive care units of the responding hospitals. Only a small proportion had protocols available for preventing VAP, which is in accordance with similar surveys conducted in the US and Europe. Additional and improved measures have to be determined to confirm or optimize prophylactic oral strategies and to create standards and guidelines for this at-risk patient collective.

Zirconia is currently extensively used in medicine, especially in orthopedic surgery for various joint replacement appliances. Its outstanding mechanical and chemical properties have made it the "material of choice" for various types of prostheses. Its color in particular makes it a favored material to manufacture dental implants. A literature search through Medline enables one to see zirconia's potential but also to point out and identify its weaknesses. The search shows that zirconia is a biocompatible, osteoconductive material that has the ability to osseointegrate. Its strength of bonding to bone depends on the surface structure of the implant. Although interesting, the studies do not allow for the recommendation of the use of zirconia implants in daily practice. The lack of studies examining the chemical and structural composition of zirconia implants does not allow for a "gold standard" to be established in the implant manufacturing process. Randomized clinical trials (RCT) are urgently needed on surface treatments of zirconia implants intended to achieve the best possible osseointegration.

The aim of this retrospective study was to evaluate the periodontal therapy performed in the undergraduate curriculum (master level) at the School of Dental Medicine at the University of Basle, Basle, Switzerland. Patients diagnosed with advanced chronic or aggressive periodontitis were included in the study, provided that they were ≤40 years of age at the initial examination and had undergone a non-surgical periodontal therapy (scaling and root planing). In the 19 patients included, a statistically significant improvement of oral hygiene (plaque index; p = 0.015) and a reduction of inflammatory parameters (bleeding index; p = 0.009; bleeding on probing⁺; p < 0.0001) were documented during supportive periodontal therapy (SPT). Sites with moderate (PD ≥5 mm; p < 0.0001 and PD ≥6 mm; p = 0.001) and high probing depths (PD ≥7 mm; p = 0.002) were significantly reduced in number, while PD <5 mm (p = 0.014) increased. Counts of single- and multi-rooted teeth could largely be maintained. The periodontal therapy in the undergraduate curriculum is a valuable treatment option for periodontally diseased patients.

Antiresorptive therapy is prescribed in particular for the treatment of osteoporosis as well as for the treatment of tumor-induced hypercalcemia and metastatic bone disease. As a consequence, osteopathologies such as bisphosphonate-related osteonecrosis of the jaws (BRONJ) may occur. In 2008, our department reported on BRONJ in a paper that provided dental clinicians with information on diagnostics, therapy, and prevention (Dannemann et al., Schweizer Monatsschrift für Zahnmedizin, Vol. 118, 2/2008). During the last 8 years, new findings have emerged concerning potential etiologies, modes of therapy, and the use of additional antiresorptive therapies. For example, an important point for colleagues in dental practice is the now common intravenous administration of bisphosphonates in osteoporosis patients, which may lead to uncertainty when assessing risk in these patients. For this reason, this article provides an update of the above mentioned publication and gives dental clinicians an updated guideline concerning risk assessment in patients undergoing antiresorptive therapy. In this context, a risk assessment algorithm is presented. The pathogenesis, diagnosis, therapy, and prevention of BRONJ and oral implantation in patients receiving antiresorptive therapy are addressed with regard to the current literature. Finally, we present two example cases.

In the present study, the oral health-related quality of life of 18 patients (13 men and 5 women) was evaluated using validated questionnaires as proposed by the European Organization of Research and Treatment of Cancer (EORTC). The patients belonged to a cohort of 48 patients, whose prosthetic treatment was performed during the years 2004-2007. In the course of tumor resection, 12 patients underwent graft surgery and 14 patients radiotherapy. One patient required a nasal epithesis since resection of the nose became necessary. Five patients underwent a full block resection of the mandible, and tumor resection in 3 patients resulted in a large oronasal communication. Prosthetic rehabilitation was performed in all patients, and the follow-up period with regular care covered a minimum of 3 years. Eleven patients received dental implants for better support and retention of the prostheses. In spite of compromised oral conditions, functional restrictions, and some difficulties with the prostheses, the answers to the questionnaire were quite positive. The majority judged their general health as good or even excellent. The subjective perception of the patients may contradict the objective view by the dentist. In fact, the individual patient's history and experience provide a better understanding of the impact of oral tumors on daily life. The overall assessment identified 4 items that were perceived as major problems by all patients: swallowing solid food, dry mouth, limited mouth opening, and appearance. Prosthetic rehabilitation has only a limited influence on such problems.