Patient Evaluation of Treatment with Fixed Prostheses Supported by Implants or a Combination of Teeth and Implants

PURPOSE: The objective of this study was to compare treatment outcomes among subjects with complete arch fixed prostheses in the maxilla, supported by implants or a combination of natural teeth and dental implants. MATERIALS AND METHODS: Twenty-one subjects with maxillary tooth- and implant-supported fixed prostheses and 21 subjects with maxillary implant-supported fixed prostheses were identified and included in the study. All abutment teeth in the group with tooth- and implant-supported prostheses were provided with cemented copings that incorporated threads for vertical locking screws. Frameworks were fabricated with a gold alloy that was veneered with acrylic resin or ceramic materials. All frameworks were screw-retained to implants and copings. Frameworks in the group with implant-supported prostheses were fabricated with milled titanium or gold alloy to which denture teeth and resin base material were applied. All prostheses had a minimum of 8 units, at least 4 of which were in one quadrant. Subjects in both groups were mailed a questionnaire consisting of 15 questions focused on various factors related to treatment outcome, such as oral function and patient satisfaction. RESULTS: The response rate was 86%. Both groups reported a high satisfaction rate for most items with few regretting their choice of treatment. Most individuals in both groups reported great improvement in chewing ability and few reported phonetic disturbances. No statistically significant differences were found between the groups. CONCLUSION: The results of the present study showed similarity in questionnaire responses between the 2 groups of participants. High satisfaction was reported both among subjects who received a complete arch fixed prosthesis in the maxilla supported by dental implants only, as well as among those whose prostheses were supported by a combination of natural teeth and dental implants.     

Long-term results of treatment for temporomandibular joint pain-dysfunction

The frequency and severity of functional disturbances of the masticatory system were studied in 154 women 7 years after treatment for TMJ pain-dysfunction at the Department of Stomatognathic Physiology, University of G?teborg, Sweden. The results of the 7-year examination were compared with records made prior to treatment. There was a significant reduction of both reported symptoms and clinical signs of dysfunction at 7 years. Although less severe than at the initial examination, clicking of the TMJ and slight muscle tenderness to palpation were the most common clinical findings at 7 years. Eighty-four percent of patients reported that treatment received had resulted in reduction of symptoms. During the 7-year period, 80% of patients had few or no symptoms. Recurrent symptoms of some significance were found in less than 20% of patients, and 14% had returned for further treatment during the 7-year period. It can be concluded that most patients with TMJ pain-dysfunction have minimal recurrent symptoms 7 years after conservative treatment procedures. This indicates that a favorable prognosis may be considered for TMJ pain-dysfunction. This favorable prognosis should be emphasized to patients prior to treatment, as optimistic counseling has been shown to have a favorable effect on patient response to treatment.     

Das Göttinger Fotostatverfahren

Zusammenfassung Methode zur Anfertigung exakt auswertbarer Fotos ohne Zephalostatgerät, auch für enge räumliche Verhältnisse geeignet. Verwendet wird Polizei-Adapter für Planfilm in Verbindung mit Linhof-Technika; die Orientierung erfolgt über eine Mattscheiben-Horizontale nach neuartigen Gesichtsmarkierungen. Es wird empfohlen, gegebenenfalls verschiedene Lippenhaltungen zu dokumentieren.

---

Summary A method is described of making clinical photos without any cephalostatic instrument. Police Adapter for flat film together with Linhof-Technika is used; the orientation is given by means of a horizontal focusing screen in accordance with new face markings. It is advisable to document different lip postures.

---

Résumé Il s'agit d'une méthode permettant de faire des photographies exactes sans l'aide d'un céphalostat et dans des conditions spatiales réduites. Le Polizei-Adapter pour film plat est utilisé avec la Linhof-Technika. L'orientation est donné par un verre dépoli horizontal en relation avec de nouveaux marquages faciaux. Il est recommandé de noter le cas échéant, différentes postures des lèvres.

---

---

Mit 8 Abbildungen

---

Herrn Prof. Dr. Dr. Th. Kirsch zum 60. Geburtstag     

Kraniometrische Merkmale bei unterschiedlichen Anomalien

Zusammenfassung Die vorangegangenen Ausführungen verfolgten das Ziel, die Frage aufzuhellen, ob für Anomalien des Kieferbereiches eine weitgehende Unabhängigkeit vom Aufbau des Gesichtsschädels besteht. Zu diesem Zweck wurden je 10 Fernröntgen-Profilaufnahmen von 5 typischen Anomaliegruppen ausgewählt und im Hinblick auf die Fragestellung ausgewertet. Das mit Hilfe biostatistischer Verfahren gewonnene Ergebnis gibt zu erkennen, daß keine der gewählten Variablen des Gesichtsschädels eine spezifische Zuordnung zu einer bestimmten Anomaliegruppe ermöglichte. Zwischen kraniometrischen Merkmalen und Gebißanomalien bestehen demnach keine engeren Beziehungen.Das Resultat der Untersuchung spricht für die Zweckmäßigkeit, die Spinaebene als Schlüssel der röntgenkephalometrischen Diagnostik zu verwenden.

---

Summary The explanations ahead shipped for screening the problem, if there exits a high degree of independence between malocclusions of the jaws and the structure of the facial complex. For this purpose respective ten lateral X-rays of five typical malocclusion-groups were selected and evaluated with regard to that question. The result gained by means of biostatic methods shows, that none of the chosen variables of the facial complex allowed a specific relation to a certain group of malocclusions. Therefore craniometric signs and malocclusions have no closer references.The result emphasizes the suitability of using the spina-plane as key for the roentgenocephalometric diagnosis.

---

---

Mit 8 Abbildungen     

Neue Gesichtspunkte zur Ätiologie der Progenie

Zusammenfassung Bei der Untersuchung unseres Progeniematerials haben wir die Folgen von drei deutlich unterscheidbaren Typen von systematischen Wachstummstörungen finden können. Die erste von diesen ist die sogenannte micro-rhine-Dysplasie, durch die die Nasen- und Zwischenkieferregion betroffen wird und die zu einer Reduktion der Gesichtshöhe mit einer kompensatorischen Hyperflektion des Unterkiefers führt. Unter gewissen Umständen kann diese Kompensation des Höhendefizits im Mittelgesicht auch zu einem progenen Kreuzbiß führen. Die zweite Wachstumsstörung wird microte Dysplasie genannt und betrifft die temporale und okzipitale Region der Schädelbasis und führt zu einem Gelenkvorstand und daraus folgend zu einer Klasse III-Verzahnung. Diese beiden Wachstumsstörungen können als leichte Manifestationen von kranio-fazialen Mißbildungen aufgefaßt werden, die in der Embryologie als Arhinenzephalie und Otozephalie bekannt sind. Schließlich wird ein dritter Typ einer Wachsstumstörung unter dem Namen leptoide Dysplasie beschrieben, bei der das sagittale Wachstum des Gesichts im allgemeinen herabgesetzt ist, wogegen das Vertikalwachstum betont gefunden wird. Von dieser Wachstumsanomalie wird besonders auch der Unterkieferknochen als Einzelelement betroffen und läßt diesselben hypo- und hyperplastischen Abweichungen von der normalen Wunschform erkennen.

---

Summary In our class III material we have seen the sequelae of three distinct types of systemic growth disturbances. The first of these is called micro-rhinic dysplasia and involves the nasal and premaxillary region and results in a reduction of facial height with compensatory overclosure of the mandible. Under certain circumstances this deficiency in the vertical dimension leads to an anterior crossbite.The second is called microtic-dysplasia and involves the temporal and occipital regions of the base of the skull and results in a forward position of the TM joints and consequently in a class III malocclusion. The two of them can be regarded as slight manifestations of craniofacial malformations known in Embryology as Arhinencephaly and Otocephaly.Finally a third type is described under the name of leptoid dysplasia in which the sagittal growth of the face in general is reduced while the vertical growth is pronounced.The mandible is likewise involved showing at the same time hypo- and hyperplastic deviations from the normal growth.

---

---

Mit 15 Abbildungen

---

Herrn Professor Dr. E. Hausser zum 60. Geburtstag     

Anthropologische Studie über das Kinn an württembergischen und außereuropäischen Schädeln

Ohne ZusammenfassungMit 14 AbbildungenReferat, gehalten auf der Wissenschaftlichen Jahrestagung der Deutschen Gesellschaft für Kieferorthopädie vom 21. bis 24. Mai 1964 in Salzburg.     

Behandlungsergebnisse nach chirurgischer Therapie von Basalzellkarzinomen im Kopf-Hals-Bereich unter Berücksichtigung unterschiedlicher Rekonstruktionsverfahren

Background

Basal cell carcinomas are the most frequently occurring malignant tumors in the white population. They exhibit a multitude of histological/morphological forms.

Patients and method

All cases of basal cell carcinoma treated at the department for oral and maxillofacial and regional plastic surgery of the HELIOS hospital in Erfurt between 1976 and 2003 were analyzed and partly reexamined in a retrospective study.

Results

A total of 648 patients with 765 basal cell carcinomas were treated. Occurrences in females dominated those in males with a frequency distribution of 1.24:1. The average age was 70.6 years with a significantly larger number of female seniors above 60. In 64% of the cases the basal cell carcinomas were nodular, in 16% infiltrative. Other morphological/histological forms occurred with a frequency of ≤5%. The most frequent localizations were in of the regions of the highest sun exposure such as the nose, midface, and forehead.

Discussion

If an infiltrative basal cell carcinoma is suspected or insufficient radical primary surgery is presumed, plastic reconstruction should be postponed until free margins can be confirmed histologically. The functional and aesthetic quality of reconstruction was better using pedicled flaps (90%) and primary closure (86%) than using free skin transplants (30–54%). Nevertheless, free skin flaps and epitheses were found to be well accepted by the reexamined patients.     

Investigations on the Influencing of the Subgingival Microflora in Chronic Periodontitis

AIM: The aim of the present study was to investigate changes in the subgingival flora in adults with chronic periodontitis undergoing orthodontic fixed appliance therapy. PATIENTS AND METHODS: In seven adult patients who had undergone nonantibiotic periodontal pretreatment, the subgingival bacteria were subjected to microbiological examination and the number of periodontopathogenic organisms was determined before (T1: prior to treatment being started), during (T2: 6 weeks after orthodontic treatment was started) and after the end of orthodontic treatment (T3: 6 weeks after removal of the fixed appliances). RESULTS AND CONCLUSION: During the fixed appliance therapy (metal brackets, NiTi archwires, stainless steel archwires), a marked reduction was observed in the total bacteria count from the subgingival pocket despite the clinical periodontal parameters remaining almost unchanged. However, the total count of some highly pathogenic bacteria rose again slightly after the end of treatment. We attribute the marked improvement in the periodontopathogenic bacteria spectrum under fixed appliance therapy with metal brackets, NiTi archwires and stainless steel archwires to metal corrosion entailing the release of primarily nickel ions, which have a toxic effect on bacteria and thus enable the regeneration of the physiological bacterial flora. In none of the patients was a deterioration of the periodontal status observed during and after fixed appliance therapy.