A Comparison of the Periodontal Health of Patients during Treatment with the Invisalign? System and with Fixed Orthodontic Appliances

Objective:   

Evaluation of the periodontal health in patients during treatment with either fixed orthodontic appliances or the Invisalign^® system.     

Auswirkungen von Bändern und Brackets auf das marginale Parodontium

Zusammenfassung Die Zähne von zwölf kieferorthopädischen Patienten wurden wechselweise bebändert und beklebt; nicht in die Behandlung einbezogene Zähne dienten als Kontrollzähne. Bei diesen Patienten wurden über mehr als ein Jahr folgende parodontologische Untersuchungen durchgeführt: Papillenblutungsindex, Gingival-index, Plaqueindex und Sondierungstiefe; hinzu kam eine mikrobiologische Prüfung der gingivalen Plaque mit Hilfe der Dunkelfeldmikroskopie. Dabei wurden folgende Ergebnisse gefunden: 1. Selbst vor Aufnahme der Behandlung ist die marginale Gingiva propria in der Regel nicht entzündungsfrei. 2. Durch Mundhygieneinstruktionen kann kurzfristig eine Verbesserung dieses Zustandes erzielt werden. 3. Im Laufe der kieferorthopädischen Behandlung nimmt der Entzündungsgrad der Gingiva kontinuierlich zu, besonders deutlich nach dem achten Monat. 4. Abgesehen vom Plaqueindex war der parodontale Zustand der bebänderten Zähne spätestens nach einem Jahr signifikant (p0,05) schlechter als der mit Adhäsivbrackets versehenen Zähne. 5. Fast regelmäßig ergab die Dunkelfeldmikroskopie signifikante Unterschiede für alle drei Zahnkategorien. Als Gesamtergebnis zeigte sich, daßunter parodontologischen Aspekten das Bekleben der Zähne einem Bebändern vorzuziehen ist.

---

Summary The teeth of 12 orthodontically treated patients were alternately banded or bonded; teeth not included in active treatment served as control teeth. During a period of more than 1 year the periodontal conditions were assessed by the papilla-bleeding-index, the gingival-index, the plaque-index, and depth of the gingival sulcus. In addition a microbiological examination of the gingival plaque with darkfield microscopy was undertaken. The following results were obtained: 1. Even prior to the beginning of treatment the marginal gingiva propria is usually not free of inflammation. 2. Following oral hygiene instruction, improvement can be achieved, but only for a short period of time. 3. During the course of orthodontic treatment the degree of inflammation steadily increases and is particularly significant after the 8th month. 4. By the 12th month the periodontal status—beside the plaque-index—of the banded teeth was significantly (p0,05) worse than that of the bonded teeth. 5. Almost regularly the darkfield microscopy revealed significant differences in all three tooth categories. In conclusion, it is preferable from aperiodontal point of view, to place bonded brackets on teeth rather than bands.

---

Résumé Les dents de 12 patients furent traitées alternativement à l'aide d'anneuax et de brackets collés; les dents non traitées servaient de contrôle. L'état de leur parodonte marginal fut régulièrement examiné pendant une année et plus (index de saignement papillaire, index gingival, index de plaque, profondeur de poche). La période d'observation se termina par un examen bactériologique avec un microscope à fond noir. Les résultats suivants furent trouvés: 1. Une inflammation gingivale fut pratiquement de règle avant le traitement. 2. Cet état put être amélioré transitoirement par des instructions d'hygiène orale. 3. Le degré d'inflammation gingivale augmenta continuellement au cours du traitement et ce particulièrement après le 8e mois. 4. Indépendamment de l'index de plaque, l'état parodontal des dents baguées fut significativement (p0,05) plus mauvais, au plus tard après 12 mois, par rapport aux dents munies de brackets collés. 5. Les résultats des examens bactériologiques à fond noir donnèrent presque toujours des différences significatives pour les trois catégories de dents. En conclusion il semble que du point de vue parodontal l'utilisation de brackets est préférable à celle d'anneaux.

     

A microsatellite-based,physically anchored linkage map for the gray,short-tailed Opossum (<Emphasis Type="Italic">Monodelphis domestica</Emphasis>)

The genome of the gray, short-tailed opossum, Monodelphis domestica, will be the first of any marsupial to be fully sequenced. The utility of this sequence will be greatly enhanced by construction and integration of detailed genetic and physical maps. Therefore, it is important to verify the unusual recombinational characteristics that were suggested by the ‘first-generation’ M. domestica linkage map; specifically, very low levels of recombination and severely reduced female recombination, both of which are contrary to patterns in other vertebrates. We constructed a new linkage map based on a different genetic cross, using a new and much larger set of map markers, and physically anchored and oriented the linkage groups onto chromosomes via fluorescence in-situ hybridization mapping. This map includes 150 loci in eight autosomal linkage groups corresponding to the eight autosome pairs, and spans 86–89% of the autosomal genome. The sex-averaged autosomal map covers 715 cM, with a full-length estimate of 866 cM; the shortest full-length linkage map reported for any vertebrate. The sex-specific maps confirmed severely reduced female recombination in all linkage groups, and an overall F/M map ratio =  0.54. These results greatly extend earlier findings, and provide an improved microsatellite-based linkage map for this species. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Heat shock protein 60 from Chlamydia pneumoniae elicits an unusual set of inflammatory responses via Toll-like receptor 2 and 4 in vivo

Heat shock protein 60 (HSP60) from Chlamydia pneumoniae was described to trigger in vitro inflammatory and cytokine responses including TNF and IL-12p40. Although it can be found in atherosclerotic plaques of patients, the stimulatory potential of chlamydial and other HSP60 in vivo is unclear. We now report that chlamydial HSP60 fails to induce TNF expression in vivo, and significant serum levels of IL-12p40 are only found upon intraperitoneal injection of high doses of HSP60 or after intravenous application. Upon purification of chlamydial HSP60 with polymyxin B-agarose columns, its ability to induce TNF secretion in vitro is much reduced. However, purified chlamydial HSP60 causes increased serum levels of the CXC chemokines KC and MIP2 in vivo, as well as a strong accumulation of polymorphonuclear neutrophils (PMN) in the peritoneal cavity upon intraperitoneal challenge. With respect to PMN accumulation, chlamydial HSP60 is more potent than endotoxin or the CpG oligonucleotide 1668. The responses observed are completely abolished in Toll-like receptor (TLR)2/4-double-deficient mice, while single-deficient mice respond almost normally. Furthermore, KC induction and PMN accumulation are largely dependent on MyD88. In conclusion, HSP60 from C. pneumoniae triggers inflammatory responses in vivo that differ from responses induced by endotoxin or CpG oligonucleotides and are dependent on TLR2 and 4.     

Primary activation of murine CD8 T cells via cross-linking of T3 cell surface structures: two signals regulate induction of interleukin 2 responsiveness

In the model system used here to study the minimal signal requirements for the activation of murine resting CD8 T cells, cross-linking of T cell receptor structures by antigen-presenting cells is substituted for by the use of anti-CD3 monoclonal antibodies immobilized in Sepharose beads. We show that cross-linking of CD3 structures, even in combination with CD8 structures, is necessary but insufficient to induce responsiveness to the growth-promoting effect of interleukin 2 (IL2), i.e. fails to induce expression of functional IL2 receptors. A macrophage cell line product termed IL2 receptor-inducing factor (RIF), but not IL1, IL3, IL4 or tumor necrosis factor, efficiently functions as costimulator. Once activated, growth of CD8 T cells is entirely driven by IL2. We conclude that two restriction points control the activation of resting CD8 T cells. While cross-linking of CD3 structures is essential as a first step, RIF is required as competence factor to induce IL2 responsiveness. We consider the possibility that the ability of antigen-presenting cells to produce RIF determines the immunogenicity of presented antigen towards antigen-reactive resting CD8 T cells.     

Rekonstruktion von Segmentdefekten der langen Röhrenknochen

Surgery of malignant tumors and the subsequent outcome after treatment of complicated fracture situations of long bones often result in major bone defects. In addition to bridging of defects and stabilization with allogenic implants, defect reconstruction by callus distraction with segment transport and vascularized free fibula transfer are the procedures of choice for defect reconstruction in long bones. The heterogeneity of the causes of large bone defects and specific comorbidities of the patients require a differentiated approach. The indications and characteristics of the various surgical approaches and current developments in procedures for reconstruction of large defects in long bones are presented.     

Predictors of outcome in patients with normal-pressure hydrocephalus

Despite emerging knowledge of over 40 years, the postoperative results after shunt implantations in patients diagnosed for normal-pressure hydrocephalus (NPH) have not improved significantly in the last decade. For this reason, predictors have to be identified in order to preoperatively predict the course of disease. From 1982 to 2000, we examined in a prospective study 200 patients diagnosed for NPH. Of the patients who were surgically treated by a shunt implantation we could re-examine 155 (78%) in a mean time interval of 7 months after operation. The NPH was graduated according to the results of the intrathecal infusion test in an early state NPH (without brain atrophy) and late state NPH (with brain atrophy). In the study we focused our attention on the possible predictors: patient's age, length of disease, clinical signs--like gait ataxia, dementia and bladder incontinence, etiology idiopathic/secondary as well as implanted valve type and the value of resistance to cerebrospinal fluid outflow. To measure the outcome we used the NPH recovery rate, as statistical test the chi(2) according to Pearson. In 80 patients with an early stage NPH (without cerebral atrophy) and a short course of disease (<1 year), slightly distinct dementia and an implanted Miethke Dual-Switch valve were significant predictors for a positive postoperative outcome. The outflow resistance measured in the intrathecal infusion test showed only a minimal relevance for the outcome. Those 75 patients with a late state NPH (with cerebral atrophy) had a better outcome when dementia was not present, the outflow resistance was >20 mm Hg.min/ml, the CSF tap test was positive and a Miethke Dual-Switch valve was implanted.