This current study investigated which angle of canine inclination (angle between canine tooth axis (CA-line) and the line between the lateral canthus and the ipsilateral labial angle (EM-line)) is perceived to be most attractive in a smile. The second objective was to determine whether laymen and dental experts share the same opinion. A Q-sort assessment was performed with 48 posed smile photographs to obtain two models of neutral facial attractiveness. Two sets of images (1 male model set, 1 female model set), each containing seven images with incrementally altered canine and posterior teeth inclinations, were generated. The images were ranked for attractiveness by three groups (61 laymen, 59 orthodontists, 60 dentists). The images with 0° inclination, that is CA-line (maxillary canine axis) parallel to EM-line (the line formed by the lateral canthus and the ipsilateral corner of the mouth) (male model set: 54·4%; female model set: 38·9%), or -5° (inward) inclination (male model set: 20%; female model set: 29·4%) were perceived to be most attractive within each set. Images showing inward canine inclinations were regarded to be more attractive than those with outward inclinations. Dental experts and laymen were in accordance with the aesthetics. Smiles were perceived to be most attractive when the upper canine tooth axis was parallel to the EM-line. In reconstructive or orthodontic therapy, it is thus important to incline canines more inwardly than outwardly.

Purpose: Magnetic resonance imaging (MRI) is one of the most widely used noninvasive diagnostic modalities for musculoskeletal evaluation. We conducted a retrospective study to determine whether MRI of the hip joint abductor and external rotator muscles yields reproducible findings in patients after total hip arthroplasty (THA).Materials and methods: MR images were obtained 12 months after THA in 10 patients and were analyzed by two independent, blinded observers. The images were analyzed on workstations with three-dimensional analysis capabilities. The readers evaluated the gluteus medius, gluteus minimus, and obturator externus muscles on the nonoperated side (NOS) and the THA side. For each of the three muscles, the readers analyzed the cross-sectional area, cross-sectional signal intensity, intensity in a region of interest (ROI), and volume on both sides.Results: Unlike intraobserver variability, interobserver variability showed significant differences between the measurements for some abductor and external rotator muscles, especially for volume (p < 0.001-0.02) and cross-sectional area (p < 0.001-0.05) analysis of the gluteus medius and minimus muscles on the THA side but also on the NOS. There were no differences in signal intensity in the ROI (p = 0.29-0.83). The coefficients of variation (CoV) of all 4 parameters quantified were lower on the NOS (average, 5.9%) than on the THA side (average, 7.3%). Analysis of the gluteus minimus muscle volume showed both higher intraobserver (18.8%) and interobserver (13.9%) variability on the THA side.Conclusion: MRI is an accurate and reliable test for evaluation of soft tissue structures in patients who have undergone THA. MRI evaluation of abductor muscles yields reproducible results on the THA side and on the NOS. Prosthesis artifacts limit evaluation of the gluteus minimus muscle on the THA side and cannot be recommended. Since interobserver variability was always higher than intraobserver variability, follow-up examinations should ideally be performed by the same reader in order to obtain clinically meaningful results. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Wir berichten über die ungewöhnliche Manifestation und Therapie eines Dermatofibrosarcoma protuberans im Gesicht.

We here report on the unusual manifestation and management of a Dermatofibrosarcoma protuberans in the face.

Aims: In light to association of increased platelet glycoprotein la (GPIa) expression with tumor invasion and metastasis in several types of cancer, we investigated the possible contribution of a common polymorphism (C-807/T-807), affecting the GPIa gene expression, in the development of oral cancer.Methods: DNA samples of 110 patients with oral cancer and 114 healthy controls were examined by allele-specific polymerase chain reaction followed by electrophoretic analysis.Results: The mutant T-807 allele homozygotes were significantly increased in the group of patients compared to the control group (P < 0.001). Furthermore, significantly increased frequency of mutant alleles compared to controls was observed in the subgroup of patients with a positive history for cancer (P<0.01).Conclusions: The obtained results indicate that the C-807/T-807 polymorphism is indeed a genetic predisposing factor which contributes to increased risk for oral cancer. (C) 2006 Elsevier Ltd. All rights reserved.

In 2004, we reported a novel method of repairing a human mandible by in vivo tissue engineering. The patient served as his own bioreactor as the exogenously prepared customized mandible replacement was grown inside his latissimus dorsi muscle prior to transplantation to repair the existing defect. Our technique was developed through extensive experience with an animal model. We describe our and the patient's experiences with this procedure. We give details to the benefits and limitations of this technique as it stands and outline issues that should be addressed in future human clinical trials.

In 2007, the International Commission on Radiological Protection (ICRP) revised estimates of the radiosensitivity of tissues including those in the maxillofacial region. The authors conducted a study to reassess patients' risk related to common dental radiographic exposures using the 2007 ICRP recommendations.The authors used a tissue-equivalent head phantom to measure dose. They calculated effective doses by using both 1990 and revised 2007 ICRP recommendations. Effective dose is a calculation that takes into consideration the different sensitivities of organs to long-term effects from ionizing radiation. It is the preferred method for comparing doses between different types of exposures.Effective doses (per the 2007 ICRP) in microsieverts were as follows: full-mouth radiographs (FMX) with photo-stimulable phosphor (PSP) storage or F-speed film with rectangular collimation, 34.9 μSv; four-image posterior bitewings with PSP or F-speed film with rectangular collimation, 5.0 μSv; FMX using PSP or F-speed film with round collimation, 170.7 μSv; FMX with D-speed film and round collimation, 388 μSv; panoramic Orthophos XG (Sirona Group, Bensheim, Germany) with charge-coupled device (CCD), 14.2 μSv; panoramic ProMax (Planmeca, Helsinki, Finland) with CCD, 24.3 μSv; posteroanterior cephalogram with PSP, 5.1 μSv; and lateral cephalogram with PSP, 5.6 μSv. These values are 32 to 422 percent higher than those determined according to the 1990 ICRP guidelines.Although radiographs are an indispensable diagnostic tool, the increased effective doses of common intraoral and extraoral imaging techniques are high enough to warrant reconsideration of means to reduce patients' exposure.Clinicians can reduce patients' dose substantively by using digital receptors or F-speed film instead of D-speed film, rectangular collimation instead of round collimation and radiographic selection criteria.

In light of the recently observed contribution of thrombosis-related factors to carcinogenesis, we investigated the possible association of plasminogen activator inhibitor-1 (PAI-1) with increased risk for oral cancer. In DNA samples of 104 patients with oral squamous cell carcinoma and 106 healthy controls of comparable ethnicity, age and sex, we studied the 4G/5G polymorphism in the PAI-1 gene, which affects its expression. The mutant 4G allele and carrier frequencies were significantly increased in patients compared to controls (65.9% versus 49.5%; 88.5% versus 69.8% respectively, P < 0.01). That increase was even higher in patients with a positive family history for thrombophilia or without one for cancer (P < 0.001). Interestingly, significant difference from controls was observed only in patients with cancer stages I and II. These findings suggest that the 4G allele, by resulting in higher PAI-1 expression, is a major contributing factor in early stages of oral oncogenesis. Possibly, increased PAI-1 promotes initial development of oral cancer through regulation of cell detachment and delays further tumor progression by inhibiting vascularization.

Zielsetzung: Einige osteologische Fragestellungen erfordern die exakte Ermittlung der durch eine regenerative Technik erzielten Ergebnisse. Hierzu werden bis dato zwei Versuchstiergruppen (eine zur Erstellung histologischer Präparate und eine weitere für mazerierte Knochenpräparate zur Oberflächenanalyse) benötigt. Ziel dieser Untersuchung war die Bestimmung von Knochenvolumen, Knochendichte und Regeneratform im Seitenvergleich an jeweils einem Präparat unter Anwendung der Computertomographie (CT) und Mikroradiographie. Methode: Es erfolgten verschiedene Behandlungsverfahren vollschichtiger, einseitiger Defekte des rechten Scheitelbeins des wachsenden Minischweins (2.-6. Lebensmonat): Bone Morphogenetic Protein-7 (BMP-7, n=6), Beckenkammtransplantate (n=6), Noggin (BMP-Antagonist, n=5), keine weitere Maßnahme (Kontrolle, n=5). Die Bildgebung erfolgte mittels 16-Zeilen Spiral-CT (Kollimation 1,5mm, 280mAs, 120keV, Schichtdicke 3mm, Inkrement 1,5mm, Kern H60) mit anschließender 3D-Visualisierung. Die histographischen Untersuchungen erfolgten an nicht entkalkten Sägeschliffen mittels Mikroradiographie. Ergebnisse: Unter Anwendung von BMP-7 entsprach das Knochenvolumen und die Kalottenform der nicht operierten Gegenseite. Im Falle eines Knochentransplantates war das Knochenvolumen auf den operierten Seiten im Vergleich mit den Kontrollseiten signifikant geringer (p<0,05). Die 3D-Visualisierung zeigte hier auf der operierten Seite außerdem eine unbefriedigende Rekonstruktion der Kalottenform. Die histographisch ermittelten Knochendichten korrelierten nicht mit den Dichten in der CT (rs=0,21; p=0,326). Schlussfolgerung: Da die CT neben der Volumetrie die Möglichkeit zur dreidimensionalen Oberflächenanalyse bietet, können an jeweils einem Tier morphologische und histologische Untersuchungen erfolgen und die Versuchstierzahl kann auf die Hälfte reduziert werden.

Introduction: A major goal of research in bone transplantation is the ability to avoid the creation of secondary bone defects. Experiments in minipigs have shown that it is possible to induce heterotopic bone with the aid of recombinant human bone morphogenetic protein-7 (rhBMP-7). We were able to grow an individually customized bone transplant inside the latissimus dorsi muscle of an adult male patient. This was then transplanted to repair an extended mandibular discontinuity defect.

Osteoblastic activity and neoangiogenesis

The aim of this study was to assess if the application of rhOP-1 induces accelerated consolidation of the callus in mandibular distraction osteogenesis. In seven adult Wistar rats a bilateral osteotomy of the horizontal ramus of the mandible was performed in the molar region and a custom designed distractor was mounted to the mandible. With a rate of 0.7 mm per day the device was activated bilaterally after the seventh postoperative day. After seven days of distraction two times 50 microg rhOP-1 were injected on two subsequent days directly into the callus. The contralateral side received an injection of placebo solution. The animals were killed four weeks after the end of distraction. A three-point bending test revealed a significantly higher strength of the distracted mandible in the rhOP-1 side (66.3 N vs. 30.4 N, P=0.034, paired t-test). Undecalcified histological sections were examined using microradiography and fluorescence microscopy after sequential intravital polychromic labelling. A continuous bony bridging was seen in all rhOP-1 sites and in none of the control sites. The data indicate that rhOP-1 may be an option to accelerate callus maturation in mandibular distraction osteogenesis.

Oral lichenoid reactions resemble oral lichen planus clinically and histologically and may arise in the vicinity of amalgam fillings, frequently. 108 out of 122 patients with oral lichenoid reactions were patch tested against a variety of dental materials. Patients were screened for cutaneous lichen planus by a dermatologist. The local relation of lesions to fillings in question was documented. 33 patients had positive patch test reactions to amalgam or inorganic mercury components. Amalgam fillings were replaced in 105 patients, which led to a benefit in 94 patients regardless of patch test results. In 31 patients lesions cleared completely, in 8 patients subtotally. An improvement was observed in 63 patients, no change at all in 3 patients. 17 patients refused replacement of amalgam fillings. In one of these patients lesions cleared subtotally while lesions remained unchanged in 16 patients. Amalgam removal had very little impact on intraoral lesions in patients with cutaneous lichen planus as compared to patients without cutaneous lesions. Oral lichenoid reactions may have a multifactorial etiology. We suggest that removal of amalgam restorations can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.

. Lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) are collagen cross-link residues. HP is present in most tissues, whereas LP is specific for bone and dentin. Based on the current literature there are certain indications that measurement of the concentrations of HP and LP in dentin may be a valuable tool to determine the individual age. The purpose of this investigation was to assess if the concentrations of LP and HP in dentin increase during lifetime. We have investigated 173 molars from 173 individuals (2 through 78 years of age, 31 primary and 142 secondary teeth) in the course of the present study. Levels of LP and HP were measured by HPLC and fluorescence detection. The results show that dentinal concentrations of HP and LP did not increase with age and varied between individuals of the same age and that determination of dentinal concentrations of HP and LP cannot be used to determine the individual age.