This study aimed to qualitatively and quantitatively assess the masking efficacy and color stability of resin infiltration on post-orthodontic ICL after 1 year. In 17 adolescents, 112 ICL (ICDAS-1: n = 1; ICDAS-2: n = 111) in 112 teeth were treated by resin infiltration (Icon, DMG) 3 to 12 months after bracket removal. The etching procedure was performed up to 3 times. Standardized digital images were taken before treatment (T0), 7 days (T7) and 12 months (T365) after treatment. Outcomes included the evaluation of the color differences between infiltrated and healthy enamel at T0, T7, and T365 by quantitative (colorimetric analysis (ΔE), ICDAS scores) and qualitative methods (5-point Likert scale (deteriorated (1), unchanged (2), improved, but not satisfying (3), improved and no further treatment required (4), completely masked (5)).) Differences between time points were analyzed by using Friedman test (ΔΕ) and chi-square tests (ICDAS). The median color difference (25th/75th percentiles) between carious and healthy enamel at baseline (ΔΕ0) was 10.2(7.7/13.6). A significant decrease was observed 7 days after treatment (ΔΕ7 = 3.1(1.8/5.0); p < 0.001; ICDAS; p < 0.001). No significant changes based on ΔΕ (p = 1.000), and ICDAS grade (p = 0.305) were observed between T7 and T365 (ΔΕ12 = 3.4 (1.8/4.9)). Furthermore, at T365 four experienced dentists classified 55

New opportunities have arisen to manufacture three-dimensional computer-aided design/computer-aided manufacturing (3D CAD/CAM) retainers from titanium blocks by digital cutting technology. These novel technologies need to fulfill requirements regarding digital planning and position accuracy. The aim of the present study was to investigate the digital construction, the CAD/CAM production and the intraoral positioning accuracy of custom-manufactured novel 3D CAD/CAM titanium retainers. A total of 37 prime4me® RETAIN3R (Dentaurum, Ispringen, Germany) retainers were inserted to stabilize the upper anterior front teeth. Following insertion, an intraoral scan was used to record the position. The intraoral position was compared to the virtual setup using 3D superimposition software. Measurement points were evaluated in all three dimensions (horizontal, sagittal and vertical planes). Data were analyzed using Kruskal–Wallis test followed by Dunn’s multiple comparison test. A total of 185 measurements were performed. The horizontal plane and the sagittal plane demonstrated a high level of positioning accuracy between the planned and the intraoral position. Statistically significant deviations between the preceding virtual setup and the intraoral situation were observed in the vertical dimension. Within the retainer, the intraoral positioning accuracy decreased for the measurement points in the direction of the distal retainer segment. Based on the results, the present study shows a high level of congruence between the 3D virtually planning and the final intraoral position of the fabricated novel 3D CAD/CAM titanium retainers.

Ziel/Aim Inflammation and calcification are two main processes during tooth movement, which are initiated by pressure-derived-necrosis and bone remodelling, respectively. The aim of this study is to assess the ability of Ga-68-Pentixafor and Sodium F-18-Fluoride (Na[F-18]F) to monitor the dynamics of orthodontic tooth movement in an established mouse model.

Die Korrektur von Kieferfehlstellungen wird schon seit über 100 Jahren gemeinsam von Kieferorthopäden und Mund-Kiefer-Gesichts(MKG)-Chirurgen geplant und in enger Zusammenarbeit interdisziplinär durchgeführt. Das Ziel dieses Beitrags ist, den Goldstandard der Dysgnathietherapie wissenschaftlich zu erläutern und neuere Behandlungsmöglichkeiten vorzustellen.

The aim of this prospective birth cohort study was to evaluate the effect of the programme for prevention (PP) of early childhood caries and the resulting need for orthodontic treatment in 8-year-old German children. Children who had been enrolled in a caries-risk-related recall system with continuous dental care starting at the time of birth (prevention group, PG) were compared with children of the same birth cohort whose parents decided not to participate in the programme (control group, CG). All children (n = 289) participating in the last PP evaluation at the age of 5 years were invited again and examined by blinded clinicians. Dental caries was scored using the WHO diagnostic criteria expanded to d1-level without radiography. Impressions were taken of children with premature tooth loss to analyse space conditions. Two hundred twenty-seven children (mean age 8.4 ± 0.6 years; 46.7% female) were examined. Children in the PG (n = 127) showed significantly lower caries prevalence and experience (3.1%, 0.4 ± 1.0 d3–4mft) than children in the CG (37.3%, 3.9 ± 3.5 d3–4mft). Orthodontic analysis found a higher prevalence of premature tooth extraction, followed by a greater extent of space loss in the CG (41.0%; 3.3 ± 4.4 mm) vs. PG (7.9%; 0.4 ± 1.9 mm) and an increase in early orthodontic treatment need (KIG P3, IOTN 5). The PP was an effective approach for preventing caries-related premature tooth loss in children and conserving relevant arch length. Children who received continuous dental care starting at the time of birth showed better oral health with less premature loss of deciduous teeth and lower need for orthodontic treatment at the age of 8 years. German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438

To evaluate the impact of a novel computer-fabricated lingual nitinol retainer compared to a conventional lingual flexible spiral wire twistflex retainer on oral health.

Permanent retention is currently the method of choice to stabilize orthodontic treatment results. Frequently, permanent retention schemes are adopted to prevent posttreatment changes in the esthetic zone of the anterior teeth. With increasingly prolonged times of intraoral device use, and retention to be provided in the maxilla despite limited space, the demands placed on well-planned and precise retainer positioning are becoming more exacting. The aim of the present study was to analyze the intraoral precision of lingual retainers made using computer-aided design and machining (CAD/CAM).

Introduction: With a prevalence of approximately 3%, bipolar disorder is a quite common psychiatric disease. Therapeutic drug monitoring (TDM) can be a helpful tool to optimize the therapy: The concentration of a drug in human blood (measured via HPLC-UV), not simply the dosage, is responsible for its efficacy. With this background a new UHPLC-UV method was developed for TDM-guided treatment of bipolar patients. UHPLC runs at higher pressure with smaller columns than HPLC and allows faster and more sensitive analysis of small samples (10 µl injection volume). Method: The separation was performed on a RP-C18 column with a run time of 20 minutes. The mobile phase consists of phosphate buffer pH 3/MeOH 90:10 and ACN with gradient elution from 10 to 30% ACN with a flow rate of 0.5 ml/min. The drugs are monitored using UV-detection (209 and 230 nm). Results: This method allows a rapid analysis of 8 psychiatric drugs in human serum. Comparing the analysis of Aripiprazole (ARI) and its metabolite Dehydroaripiprazole (DARI) with UHPLC and HPLC shows the advantages of the UHPLC method: The UHPLC-analysis has a run time of only 20 minutes (HPLC: 40 min) with retention times of 14,1 min (ARI) and 13,1 min (DARI) (HPLC: 30,5 min (ARI) and 27,7 min (DAR)). The new developed method is faster and needs less solvent. This allows rapid and cost saving analysis of psychiatric drugs in daily routine. Prospect: The new method has to be validated to be used in daily routine at the TDM laboratory.

BACKGROUND:The SEUSA program, the Donation and Transplantation Institute foundation consultancy program, was implemented in Trinidad and Tobago (T&T) in 2010 with the support of the National Organ Transplant Unit (NOTU) and the Ministry of Health of T&T.METHODS:The SEUSA program included (1) diagnosis of the current situation using the ODDS (Organ Donation Diagnostic Surveys); (2) creation of a human resources structure through Transplant Procurement Management (TPM); (3) detection of all brain and cardiac deaths in the hospitals implementing the DAS (Decease Alert System); (4) in-hospital awareness based on the EODS (Essentials in Organ Donation); and (5) external hospital audits. Additionally continued monitoring is performed.RESULTS:Thus far, thanks to implementation of the SEUSA program in Trinidad and Tobago 175, healthcare professionals have been exposed to training programs in the organ donation field. The Living Kidney Program was reinforced and the structure of the Deceased Donation (DD) network was defined. Since 2010, 485 potential organ donors have been detected, and 9 have become actual organ donors; 74 patients have received a kidney transplant (59 from living and 15 from deceased donors).CONCLUSIONS:This project results demonstrate that the application of the SEUSA program is an efficient methodology to develop DD programs that increase and consolidate transplant programs in the Caribbean region.

OBJECTIVES:The aim of the present study was to analyze the formation of voids and gaps in root canals obturated with different sealer materials in combination with warm gutta-percha vertical compaction technique by using BeeFill® 2in1.MATERIALS AND METHODS:Twenty-four single-rooted teeth were collected, and root canals were prepared by using rotary files. All teeth were randomly allocated into three groups. Each group was obturated by using the BeeFill® 2in1 system in combination with Sealapex (non-eugenol, calcium hydroxide polymeric root canal sealer; Kerr Sybron, USA), RoekoSeal (polydimethylsiloxane-based sealer; Roeko, Germany), or 2Seal (epoxy-amine resin-based sealer; VDW, Germany). Following preparation, all teeth were scanned with a micro-computed tomography (CT) scanner, and a three-dimensional reconstruction of the obturated root canals was performed to analyze the volume of interface voids and gaps in the obturated teeth.RESULTS:Statistical analysis demonstrated that the silicon-based sealer RoekoSeal induced significantly less voids and gaps than other tested materials. The amount of voids and gaps significantly was higher in the apical region.CONCLUSIONS:These data indicate that none of the root canal-filled teeth were free of gaps. Teeth obturated with RoekoSeal demonstrated to have the highest quality in terms of voids and gaps formation in combination with the BeeFill® 2in1 obturation system.CLINICAL RELEVANCE:These findings point to the potential benefit of micro-CT analyses for in vitro evaluation of root canal obturation systems and provide further information about sealer materials used in combination with a warm gutta-percha vertical compaction technique.

The Hutchinson–Gilford progeria syndrome (HGPS) is an exceptionally rare medical disorder caused by mutations in the lamin A/C gene. Affected patients display typical features of premature aging. Beside general medical disorders, these patients have several specific features related to the craniofacial phenotype and the oral cavity. In this article, the dental and craniofacial characteristics of a 9-year-old girl with HGPS are presented. It is the first report addressing orthodontic tooth movement and microbiological features in a HGPS patient. We describe and discuss pathologic findings and provide a detailed histology of the teeth which had to be extracted during initial treatment.

Recent studies indicate that high mobility group box protein 1 (HMGB1) can be released by necrotic and damaged cells and functions as an alarmin that is recognized by the innate immune system. Little is known about the role of HMGB1 within the periodontal ligament (PDL). Therefore, we examined HMGB1 expression by PDL cells in vitro and compared the findings to an in vivo model of orthodontically induced tooth root resorption. In addition, we addressed the question of whether a potentially anabolic intermittent administration of parathyroid hormone (iPTH) would modulate the expression of HMGB1.

Periodontal ligament (PDL) cells, a major component of the tooth supporting apparatus, share osteoblastic characteristics including their responsiveness to parathyroid hormone (PTH). Clinical studies have already pointed to the benefit of PTH in supporting regenerative processes in the craniofacial region. However, those reports did not analyze which cells mediated the PTH effect on the alveolar bone. The aim of the present study has been to further elucidate the mechanism of action of continuous PTH application on human PDL-cells mimicking a local bolus application and to analyze its intracellular signalling pathways to widen the theoretical basis for future development of reliable local PTH delivery protocols. Analyses of PDL of extracted human teeth as well as cultured human PDL-cells demonstrated strong expression of PTH-receptor-1 by immune fluorescencecytochemistry/histochemistry. To examine the effect of short time continuous PTH treatment on PDL-cell osteogenic differentiation, PDL-cells were stimulated for 48h. Analyses for mRNA and protein expression of the early osteogenic marker alkaline-phosphatase revealed an enhanced expression. Pathways analyses mediating the PTH effect resulted in a similar effect when PDL-cells were stimulated with either the signal specific fragments lacking the PKA-activating domain PTH(3-34), PTH(7-34), second-messenger-analogues PKC (PMA) or inhibitors for PKA (H8). Inhibition of the PKC-dependent pathway by stimulation with PTH(1-31), PKA second-messenger-analogue (forskolin) or PKA-inhibitor (RO-32-0432) abolished the PTH effect These data indicate abundant expression of PTH1R within the PDL and a stimulatory effect of short time continuous PTH on PDL cell differentiation towards an osteogenic phenotype and suggested local PTH application protocols as a possible treatment option in periodontal therapy.

Recent studies have shown that periodontal ligament (PDL) cells interact with macrophages from the immune system during orthodontically induced repair of periodontal tissue. Hypothesizing that high-mobility group box 1 (HMGB1) protein is released by mechanically stressed PDL cells into the extracellular space and has a role in mediating the local immune response by acting as an “alarmin”, this study was performed to further elucidate these cellular interactions, with a special focus on the impact of proinflammatory mediators secreted by PDL cells on macrophage physiology.

OBJECTIVE:Following trauma, periodontal disease, or orthodontic tooth movement, residual periodontal ligament (PDL) cells at the defect site are considered mandatory for successful regeneration of the injured structures. Recent developments in tissue engineering focus, as one pillar, on the transplantation of PDL cells to support periodontal regeneration processes. Here, we examined the ability of osteogenically predifferentiated PDL cells to undergo further osteoblastic or cementoblastic differentiation and to mineralize their extracellular matrix when transplanted in an in vivo microenvironment.MATERIALS AND METHODS:Using collagen sponges as carriers, osteogenically predifferentiated human PDL cells were transplanted subcutaneously into six immunocompromised CD-1® nude mice. Following explantation after 28 days, osteogenic and cementogenic marker protein expression was visualized immunohistochemically.RESULTS:After 28 days, transplanted PDL cells revealed both cellular, cytoplasmatic and extracellular immunoreactivity for the chosen markers alkaline phosphatase, osteopontin, PTH-receptor 1, and osteocalcin. Specific osteogenic and cementoblastic differentiation was demonstrated by RUNX2 and CEMP1 immunoreactivity. Early stages of mineralization were demonstrated by calcium and phosphate staining.CONCLUSION:Our results reinforce the previously published reports of PDL cell mineralization in vivo and further demonstrate the successful induction of specific osteogenic and cementogenic differentiation of transplanted human PDL cells in vivo. These findings reveal promising possibilities for supporting periodontal remodeling and regeneration processes with PDL cells being potential target cells with which to influence the process of orthodontically induced root resorption.

Introduction and Aims: Approximately 8% of the schizophrenic patients, whose blood was tested for clozapine, olanzapine and quetiapine in the therapeutic drug monitoring (TDM) laboratory in Regensburg, are co-medicated with beta-blockers. The three antipsychotic drugs and beta-blockers may be metabolized by the same cytochrome-P450-isoenzyme (CYP2D6) which is inhibited by representatives of both substance classes. Inhibition of the enzyme slows down the metabolism of the drugs in the patient, eventually resulting in a supratherapeutic drug concentration, thereby increasing the risk of side effects. We were interested in cross-effects of these drug-drug-interactions for both partners. Therefore, we developed a high performance liquid chromatography (HPLC) assay to simultaneously detect and quantify beta-blockers, antipsychotics and their metabolites. Methods: HPLC with ultraviolet detection used a Phenomenex Luna Phenyl-Hexyl analytical column, a linear gradient of phosphate buffered methanol and acetonitrile. Results: The HPLC method allowed TDM of 7 beta-blockers (atenolol, bisoprolol, carvedilol, metoprolol, nebivolol, propranolol und timolol), 3 antipsychotics and their metabolites (clozapine, norclozapine, olanzapine, norolanzapine und quetiapine) in serum. This method enabled determination of all substances within 18 minutes. The use of a restricted access material (RAM) column enabled us to analyse the samples without time-consuming solid-phase or liquid-liquid extraction. Conclusions: Because of short analysis time and simple handling, the developed HPLC protocol permits the use of the method for routine application in clinical laboratories. TDM of these drugs should lead to more individualized therapy, improved drug-safety and reduced treatment costs.

The effect of different BrdU-concentrations on the cysteamine-induced SCE-rate was investigated in V-79 Chinese hamster cell monolayer cultures. Both cysteamine and its auto-oxidation product cystamine act synergistically with BrdU in the induction of SCEs. A given concentration of these substances produces a low SCE-frequency at low BrdU-concentrations -- but the incidence of SCEs is significantly increased at increased BrdU-concentrations. -- Using one-cycle substitution experiments and the determination of the relative level of substitution by means of 3HBrdU-incorporation, this synergism was shown to depend on the BrdU incorporated in the DNA and on the extent to which this incorporation takes place.

Zur Ermittlung des Kontextes zwischen dem Vorliegen bakterieller Parodontitiden bei Schwangeren und dem Auftreten von Frühgeburten und niedrigem Geburtsgewicht bei Neugeborenen liegen seit Mitte der 90er-Jahre zahlreiche Untersuchungen in Sonderheit aus dem angelsächsischen Sprachraum vor. Neuere europäische Studien betonen die sozialepidemiologischen Parameter des Untersuchungsdesigns. Sie können zumindest für Schwangere in (Mittel-)Europa eine parodontitisbedingte Gefährdung der Neugeborenen empirisch nicht bestätigen. Die Notwendigkeit einer auch zahnärztlichen Schwangerschaftsbetreuung steht dabei gleichwohl außer Frage.

31 cases of non-fulminant hepatitis A complicated by acute renal insufficiency are reported in the literature. Two-thirds of those patients needed dialysis, usually when depending on the severity of their hyperbilirubinemia. This report concerns the first published case of non-fulminant cholestatic hepatitis A complicated by acute renal insufficiency in which a spontaneous remission of renal function occurred without need for dialysis despite a very severe hyperbilirubinemia.