Birgit Kruse-Lösler

Publications of Birgit Kruse-Lösler

• Melanotic neuroectodermal tumor of infancy: systematic review of the literature and presentation of a case.

  Authors: Birgit Kruse-Lösler, Christoph Gaertner, Horst Bürger, László Seper, Ulrich Joos, Johannes Kleinheinz

  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 09/2006; 102(2):204-16.

  Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, distinctive neoplasm of early infancy with rapid expansile growth and a high rate of recurrences. Most commonly the lesion affects theMelanotic neuroectodermal tumor of infancy (MNTI) is a rare, distinctive neoplasm of early infancy with rapid expansile growth and a high rate of recurrences. Most commonly the lesion affects the maxilla of infants during the first year of life, but it may also occur in the mandible, skull, brain, epididymis, and other rare locations. The origin of the tumor is the neural crest. The expansive, destructive, and rapid growth of MNTI and its effects on the surrounding tissues are the most obvious clinical features. Microscopically, large polygonal epithelioid cells resembling melanocytes, with variable deposits of melanin, and smaller neuroblast-like round cells characterize MNTI. Malignant transformation may occur. Since the first description in 1918, only 215 cases were reported up to the last extensive review in 1992. The present review supplements another 140 published cases of MNTI up to 2004, including an original case report. Clinical features, treatment alternatives, and follow-up are discussed.

• Fast element mapping of titanium wear around implants of different surface structures.

  Authors: Ulrich Meyer, Martin Bühner, Andre Büchter, Birgit Kruse-Lösler, Thomas Stamm, Hans-Peter Wiesmann

  Clinical oral implants research. 05/2006; 17(2):206-11.

  The effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biologicalThe effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biological probes. A new scanning electron microscopy-energy dispersive spectroscopy detection method was used to map the features of titanium contamination in peri-implant bone around implants with different surface structures. The amount of titanium wear was highest adjacent to titanium-plasma-sprayed surfaces, followed by sandblastered large grid acid-etched and smooth surfaces. A high sensitivity of titanium detection over large areas of bone tissue was observed. A high spatial resolution of titanium wear particles (20 nm) could be reached and correlated to the ultrastructural morphological features of peri-implant tissue. Cells adjacent to titanium wear revealed no signs of morphological alterations on a nanoscale level at early periods of implant/bone interaction. The new technique may serve as a fast and effective tool to evaluate titanium release effects in biological probes.

• Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases.

  Authors: Birgit Kruse-Lösler, Raihanatou Diallo, Christoph Gaertner, Karl-Ludwig Mischke, Ulrich Joos, Johannes Kleinheinz

  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 04/2006; 101(3):346-54.

  The clinical behavior of central giant cell granuloma (CGCG) of the jaws is variable and difficult to predict. Clinical data and follow-up information of 26 patients with CGCG were analyzed.The clinical behavior of central giant cell granuloma (CGCG) of the jaws is variable and difficult to predict. Clinical data and follow-up information of 26 patients with CGCG were analyzed. Histologic features were correlated with the clinical course of the disease. In 16 patients the CGCGs were asymptomatic; 10 lesions presented with aggressive growth, pain, massive swelling, root resorption, cortical perforation, and/or recurrence. These patients were younger and the lesions were larger than in the nonaggressive group. The histomorphometric analysis proved a significant increase in large giant cells, fractional surface area, and mitotic activity in aggressive CGCG lesions. Immunohistologic investigation (Ki-67 and p53 stain) revealed no significant differences. After surgical treatment, 3 patients with aggressive lesions developed a recurrence. The data show that clinical and histomorphometric features may be reliable indicators for the differentiation between aggressive and nonaggressive CGCG. This should be accounted for to improve the individual planning of the treatment and follow-up.

• Incision design in implant dentistry based on vascularization of the mucosa.

  Authors: Johannes Kleinheinz, André Büchter, Birgit Kruse-Lösler, Dieter Weingart, Ulrich Joos

  Clinical oral implants research. 11/2005; 16(5):518-23.

  OBJECTIVES: The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of theOBJECTIVES: The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the vessels as well as of their supply area are crucial to the decision of the incision. The aim of this study was to visualize the course of the arteries using different techniques, to perform macroscopic- and microscopic analyses, and to develop recommendations for incisions in implant dentistry. MATERIAL AND METHODS: The vascular systems of seven edentulous human cadavers were flushed out and filled with either red-colored rubber bond or Indian ink and formalin mixture. After fixation a macroscopic preparation was performed to reveal the course, distribution and supply area of the major vessels. In the area of the edentulous alveolar ridge specimens of the mucosa were taken and analyzed microscopically. RESULTS: The analyses revealed the major features of mucosal vascularization. The main course of the supplying arteries is from posterior to anterior, main vessels run parallel to the alveolar ridge in the vestibulum and the crestal area of the edentulous alveolar ridge is covered by a avascular zone with no anastomoses crossing the alveolar ridge. CONCLUSION: The results suggest midline incisions on the alveolar ridge, marginal incisions in dentated areas, releasing incisions only at the anterior border of the entire incision line, and avoidance of incisions crossing the alveolar ridge.

• Surgical treatment of persistent macrocheilia in patients with Melkersson-Rosenthal syndrome and cheilitis granulomatosa.

  Authors: Birgit Kruse-Lösler, Dagmar Presser, Dieter Metze, Ulrich Joos

  Archives of dermatology. 10/2005; 141(9):1085-91.

  BACKGROUND: Various conservative methods for treatment of labial swelling in patients with cheilitis granulomatosa have been attempted, often with only moderate success and sometimes with persistentBACKGROUND: Various conservative methods for treatment of labial swelling in patients with cheilitis granulomatosa have been attempted, often with only moderate success and sometimes with persistent disfiguring lip swelling. Severe macrocheilia can produce an unaesthetic facial deformity associated with functional disturbances. In patients with persistent macrocheilia, reduction cheiloplasty with excision of excess tissue may be indicated when conservative treatment has proven ineffective in reducing swelling but may have been successful in stabilizing disease. OBJECTIVE: To evaluate long-term results after reduction cheiloplasty in patients with macrocheilia caused by Melkersson-Rosenthal syndrome or cheilitis granulomatosa. DESIGN: Follow-up study in 7 patients with severe persisting macrocheilia, including 3 patients with Melkersson-Rosenthal syndrome and 4 patients with cheilitis granulomatosa in a stable state of disease, treated by reduction cheiloplasty at our hospital between January 1, 1987, and December 31, 2002. Preoperative and postoperative medical histories were obtained, and criteria for the success of surgical treatment were evaluated by clinical examination. Different techniques of reduction cheiloplasty are described and demonstrated in representative cases of severe macrocheilia. RESULTS: Surgical treatment in all 7 patients showed satisfying aesthetic and functional outcomes that persisted throughout follow-up (median follow-up, 6.5 years). CONCLUSIONS: Reduction cheiloplasty is an effective method to correct persistent macrocheilia and improve lip aesthetics in patients with Melkersson-Rosenthal syndrome or granulomatous cheilitis in the persistent state of disease. With careful planning, proper sequencing of treatment, and proficiency in the various surgical techniques, optimal results can be achieved.

• Histologic, histomorphometric and immunohistologic changes of the gingival tissues immediately following mandibular osteodistraction.

  Authors: Birgit Kruse-Lösler, Christian Flören, Udo Stratmann, Ulrich Joos, Ulrich Meyer

  Journal of clinical periodontology. 02/2005; 32(1):98-103.

  OBJECTIVES: Even though osteogenesis after osteodistraction has been investigated in numerous experimental studies, there is limited information focusing on the influence of well-defined mechanicalOBJECTIVES: Even though osteogenesis after osteodistraction has been investigated in numerous experimental studies, there is limited information focusing on the influence of well-defined mechanical distraction forces on the associated gingival tissues. MATERIAL AND METHODS: In a study including 48 rabbits, mandibular osteodistraction was performed in vertically osteotomized mandibular body, using defined distraction protocols with physiologic, moderate and hyperphysiologic forces. The soft tissues overlying the distraction gap were harvested finally for histologic, immunohistologic and histomorphometric investigations. RESULTS: The control group without distraction showed the typical architecture and thickness of normal gingiva. In groups with distracted mandibles, an accelerating atrophy of gingiva depending on the degree of mechanical loading was obvious, characterized by decreasing thickness of epithelial layer, loss of rete ridges and disorganization of the different cell layers with a high number of apoptotic cells. In lamina propria collagen fibres were reduced and elastic fibres increased. Histomorphometric analysis revealed significant correlation between degree of distraction and atrophy in overlying soft tissues. CONCLUSION: This rabbit model of mandibular lengthening shows an accelerating atrophy in the covering soft tissues following hyperphysiologic distraction. The long-term outcome of these distraction-related soft-tissue alterations remains unclear. The atrophic changes may likely be of temporary nature.

• Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial.

  Authors: André Büchter, Ulrich Meyer, Birgit Kruse-Lösler, Ulrich Joos, Johannes Kleinheinz

  The British journal of oral & maxillofacial surgery. 11/2004; 42(5):439-44.

  With the increased use of osseointegrated implants and with many implants functioning for a long time, the treatment of peri-implantitis has become important. Animal studies and clinical case reportsWith the increased use of osseointegrated implants and with many implants functioning for a long time, the treatment of peri-implantitis has become important. Animal studies and clinical case reports have shown that the principle of guided bone regeneration can be applied to the surgical treatment of moderate to profound loss of bone around the implant, but we have found no published clinical studies. Patients and methods: Twenty-eight patients whose ages ranged from 25 to 78 years and who had a total of 48 peri-implant defects were examined at baseline (week 0) and after 18 weeks. This included the recording of bleeding on probing, pocket probing depths, and probing attachment levels at six sites for each tooth. For 2-18 weeks before week 0 all patients had been treated for peri-implantitis, including motivation, instruction in oral hygiene, and implant scaling with a hand plastic instrument. They were then randomly allocated to continue with this treatment or to have in addition mechanical debridement and local application of Atridox trade mark which slowly release doxycycline. Results: Patients treated with Atridox trade mark showed a significantly greater gain in mean (S.D.) probing attachment levels than those not treated with Atridox. Only subjects treated with Atridox had a significant gain in mean bleeding on probing (P = 0.001). Application of the biodegradable sustained release device after initial periodontal treatment resulted in a significant gain in mean probing attachment levels in the Atridox trade mark group and a significant reduction in pocket probing depths. There was also a significant difference in mean probing attachment levels (0.6mm).

• Internet-Capable Publication Database System

  Authors: Karl-Ludwig Mischke, Birgit Kruse-Lösler, Michael Hirtz, Ulrike Ehmer

  International journal of computerized dentistry. 01/2004; 7:179-86.

  Scientific databases are generally accessible to the public via the Internet. Reports of most peer-reviewed (quotable) research is thus available to researchers and others. However, other reports andScientific databases are generally accessible to the public via the Internet. Reports of most peer-reviewed (quotable) research is thus available to researchers and others. However, other reports and information of interest to researchers and teachers such as poster presentations at congresses, articles describing techniques and teaching material, and details of vocational and continuing education courses (nonquotable literature) generally do not appear in such databases. This nonquotable literature is often of great use to teachers. A project was therefore initiated at the Münster Dental Clinic which aimed to address the problem by developing a database of all publications and other printed material produced by the staff (faculty). After a systematic search, all such publications (quotable and nonquotable) were entered in the database which is partially accessible via the Internet and fully accessible via the Münster Dental Clinic's Intranet. The complete list can be found in the protected Intranet

• Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial

  Authors: André Büchter, Ulrich Meyer, Birgit Kruse-Lösler, Ulrich Joos, Johannes Kleinheinz

  British Journal of Oral and Maxillofacial Surgery.

  With the increased use of osseointegrated implants and with many implants functioning for a long time, the treatment of peri-implantitis has become important. Animal studies and clinical case reportsWith the increased use of osseointegrated implants and with many implants functioning for a long time, the treatment of peri-implantitis has become important. Animal studies and clinical case reports have shown that the principle of guided bone regeneration can be applied to the surgical treatment of moderate to profound loss of bone around the implant, but we have found no published clinical studies. Patients and methods: Twenty-eight patients whose ages ranged from 25 to 78 years and who had a total of 48 peri-implant defects were examined at baseline (week 0) and after 18 weeks. This included the recording of bleeding on probing, pocket probing depths, and probing attachment levels at six sites for each tooth. For 2–18 weeks before week 0 all patients had been treated for peri-implantitis, including motivation, instruction in oral hygiene, and implant scaling with a hand plastic instrument. They were then randomly allocated to continue with this treatment or to have in addition mechanical debridement and local application of Atridox™ which slowly release doxycycline. Results: Patients treated with Atridox™ showed a significantly greater gain in mean (S.D.) probing attachment levels than those not treated with Atridox. Only subjects treated with Atridox had a significant gain in mean bleeding on probing (P = 0.001). Application of the biodegradable sustained release device after initial periodontal treatment resulted in a significant gain in mean probing attachment levels in the Atridox™ group and a significant reduction in pocket probing depths. There was also a significant difference in mean probing attachment levels (0.6 mm).