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ABSTRACT: The aim was to evaluate the knowledge about bisphosphonate-related osteonecrosis of the jaws (BRONJ). A bibliographic search in Medline, PubMed and the Cochrane Register of controlled clinical trials was performed between 2003 and 2010 by using the terms bisphosphonate and osteonecrosis of the jaw. The amount of publications per year, the type of journal for publication, and the evidence level of the trial were evaluated. Next to this the incidences and the success of treatment strategies for BRONJ were identified. A total of 671 publications were reviewed. Since 2006 more than 100 publications on BRONJ per year (with an upward trend) have been published, mostly in dental journals. The evidence level could be determined for 176 publications and only one grade Ia study was found. The studies showed a wide variety in design, most of them being retrospective. The incidence of BRONJ is strongly dependent on oral or intravenous application and varies between 0.0% and 27.5%. There is no scientific data to sufficiently support any specific treatment protocol for the management of BRONJ. Further clinical studies are needed to evaluate the incidence and treatment strategies at a higher level of evidence. Therefore uniform study protocols would be favourable.
Oral Oncology 04/2012; 48(10):938-47. · 2.86 Impact Factor
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ABSTRACT: The surgical exposure of dental implants can be performed by means of scalpel, punch, or, with less bleeding, by means of CO2 laser. Possible overheating of the peri-implant bone tissue should be avoided. The goal of this study was to examine the temperature changes on implants under CO2 laser irradiation (Luxar CO2 20 SP laser from POLYMED, Glattbrugg, Switzerland).
Straumann® implants were irradiated with continuous wave (cw), continuous wave with super-pulse (cw/sp), and pulsed wave (pw). The irradiation power was 4, 5, 6, 7, 8, 9, and 10 W and the irradiation times were 10, 20, 30, and 60 s. Similar temperature changes occurred in cw/sp mode and cw mode, but substantially higher temperatures appeared in pulsed wave mode.
The quickest temperature changes were observed with cw/sp irradiation (+0.5°C to +41.1°C, depending on the irradiation parameters). Beyond 20 s and 8 W irradiation, a rise exceeding 10°C on the implant surface was found.
Implant diameter and length as well as the setting parameters of the CO2 laser (irradiation power, irradiation time, and irradiation mode) are important factors to consider so that risk-free implant exposure can be accomplished. Ignoring these factors causes a risk of pathological heating of the irradiated implants and thus the surrounding tissue, which can result in the loss of an implant.
Annals of maxillofacial surgery. 01/2012; 2(1):12-16.
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ABSTRACT: Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing/recovering from chemo-/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases. The use of a toothbrush is the most important measure for oral hygiene. Toothbrushes with soft bristles operated carefully by hand or via an electric device help to remove plaque and to avoid mucosal trauma. A handlebar with a grip cover can be helpful for manually disabled patients or for those with reduced motor skills. In case of oral hygiene at the bedside or of patients during/after chemo-/radiotherapy a gauze pad can be helpful for gently cleaning the teeth, gums and tongue. The use of fluoride toothpaste is imperative for the daily oral hygiene. Detergents such as sodium lauryl sulphate improve the cleaning action but may also dehydrate and irritate the mucous membrane. The use of products containing detergents and flavouring agents (peppermint, menthol, cinnamon) should therefore be avoided by bedridden patients or those with dry mouth and sensitive mucosa. Aids for suitable interdental cleaning, such as dental floss, interdental brushes or dental sticks, are often complicated to operate. Their correct use should be instructed by healthcare professionals. To support dental care, additional fluoridation with a fluoride gel or rinse can be useful. Products further containing antiseptics such as chlorhexidine or triclosan reduce the quantity of bacteria in the mouth. For patients undergoing or having undergone radio-/chemotherapy, a mouthwash that concomitantly moisturizes the oral mucosa is advisable.
Current problems in dermatology 01/2011; 40:107-15.
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ABSTRACT: Results of immediately loaded implants are presented. 34 patients with 136 interforaminal MonoType implants (Straumann,Basel, Switzerland) were included in the study. The bar retention was manufactured fter the operation, inserted and covered with a hybrid prosthesis. 28 patients showed up for the follow-up study, the average time range was three years. Five implants were rated as failures, the cumulative six-year success rate being 94%. Interforaminal immediately loaded MonoType implants in edentulous patients showed very good results, comparable to similar studies with different systems.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 01/2011; 121(3):235-49.
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ABSTRACT: To present results of a survey on the status of implantology in Switzerland in 2006.
A questionnaire was sent to all SSO (Swiss Dental Society) members asking for personal (anonymous) background data and their implantology concepts. Specific questions dealt with level of recognition of implants, use of implants, superstructures, success and failure rates, recall and training.
A total of 1568 (47.3%) of the 3315 questionnaires were returned. Straumann, Nobel Biocare, 3i, SPI and Frialit were the most commonly used implant systems in Switzerland. Almost two-thirds (63.8%) of the dentists placed more than 20 implants per year. Long-term prognosis was the crucial factor, whereas material costs played a minor role. The edentulous mandible was the indication of choice, whereas the edentulous maxilla applied less. Almost every dentist active in implantology followed continuing educations programs in the field.
Compared to a study undertaken 12 years ago, the number of dentists engaged in implantology doubled, meaning at least one-third of non-hospital dentists in Switzerland were involved in dental implantology. Overall, willingness to extend the therapeutic range has greatly increased.
European Journal of Oral Implantology 01/2010; 3(1):71-4. · 1.67 Impact Factor
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ABSTRACT: To present results of a survey on the status of implantology in Switzerland.
A questionnaire was sent to all SSO (Swiss Dental Society) members asking for personal (anonymous) background data and their implantology concepts. Specific questions dealt with level of recognition of implants, use of implants, superstructures, success and failure rates, recall and training.
Straumann, Nobel Biocare, 3i, SPI and Frialit are the most commonly used implant systems in Switzerland. Almost two thirds (63.8%) of the dentists place more than 20 implants per year. Long-term prognosis is the crucial factor, whereas material costs play a minor role. The edentulous lower jaw is the indication of choice, whereas the edentulous upper jaw applies less. Almost every dentist active in implantology follows continuing education programs in the field.
Compared to a study undertaken twelve years ago the number of dentists engaged in implantology doubled, meaning at least one third of non-hospital dentists in Switzerland are involved in dental implantology. Overall the willingness to extend the therapeutic range has greatly increased.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 01/2010; 120(2):133-40.
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ABSTRACT: Infectious diseases transmitted by actinomycosis species cause severe destructive lesions. This rare and specific infection is mainly found in the orofacial regions. Causes of any hard tissue swelling in the jaw have, thus, to be assessed carefully. When actinomycosis is identified, a surgical intervention with curettement, draining and long-term antibiosis is required. The aim of the current article is to describe two clinical cases and to show the necessity of both, microbiological and histological laboratory diagnostics, to hedge the clinic diagnosis.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2009; 119(3):239-51.
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ABSTRACT: Panoramic radiography is a basic diagnostic tool in the dental field where calcifications are seen occasionally in the lateral parts of the x-ray. The differential diagnosis are carotid artery atheromas, calcified submandibular lymphnodes and sialoliths of the submandibular gland. 4007 panoramic radiographs (100%) from patients >40 years were scanned retrospectively. Special emphasis was given to the carotid artery territory (CAT). 225 soft tissue calcifications were found (5.6%). 144 patients had calcifications in the CAT (3.6%), 73 showed calcified submandibular lymphnodes (1.8%), and 8 (0.2%) sialoliths. The female to male ratio was 54.7%:45.3%. Pneumatic diseases were beside hypertension and smoking a risk factor for CAT calcification. Carotid artery atheromas are the main risk for cerebrovascular insults. Dentists can help to detect patients at risk for stroke. Their patients can be referred for further diagnostics (ultrasound).
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 01/2009; 119(10):1009-18.
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J Thomas Lambrecht
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ABSTRACT: Antibiotics are used for prophylactic and therapeutic purposes. Since bacterial resistances constantly change the existing conditions, the patient's therapy needs to be monitored periodically and adjusted to the changed conditions. Clinicians should be very careful about prescribing antibiotics for prophylactic purposes. But with regard to risk patients--especially when there is a risk of endocarditis--antibiotic prophylaxis is essential. Antibiotic therapy is absolutely necessary as a supporting treatment for primary surgery if the patient has acute osteomyelitis, transmitted abscesses, or multiple space abscesses. It might also become necessary to refer the patient to an appropriately equipped center or clinic.
Quintessence international (Berlin, Germany: 1985) 10/2007; 38(8):689-97. · 0.64 Impact Factor
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ABSTRACT: To collect, retrospectively, long-term results from patients who received immediately loaded Straumann implants with bar-retained overdentures.
The surgical and prosthetic treatment took place between 1981 and 1991 at the Department of Oral Surgery, Oral Radiology, and Oral Medicine, University of Basel. In each case on the day of the operation, the patients were fitted with a bar that was immediately loaded with a hybrid prosthesis. Patients who were available at the time of this study were clinically reexamined and statistically assessed.
Among the 44 patients who received 176 interforaminal Straumann implants (4 implants per patient), follow-up was possible in 23 patients, who had received a total of 89 implants. The mean observation time for the implants was 12.2 years (8 to 18 years). Three implants were lost. Five implants did not meet the predetermined success criteria. Using the definition by Cutler and Ederer, the probability of success was 83.3%.
The results show that the requisite 4-month healing time for immediately loaded interforaminal Straumann implants with bars does not have to be observed.
Quintessence international 03/2007; 38(2):111-9. · 0.76 Impact Factor
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ABSTRACT: There are no studies verifying that mefenamic acid is more effective than other NSAID (= non-steroidal anti-inflammatory drugs). However, there are several notions in the literature that this drug is less well-tolerated than other NSAID because over a prolonged period of application more lesions of the upper gastro-intestinal tract are induced as well as occasionally renal insufficiency. Compared to other NSAID the systemic toxicity starts already with relatively low doses above the maximal daily dose. Considering current knowledge there is no reason to prefer mefenamic acid to other NSAID.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2007; 117(1):12-8.
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ABSTRACT: Cone beam computed tomography allows high quality 3D images of cranio-facial structures. Although detail resolution is increased, x-ray exposition is reduced compared to classic computer tomography. The volume is analysed in three orthogonal plains, which can be rotated independently without quality loss. Cone beam computed tomography seems to be a less expensive and less x-ray exposing alternative to classic computer tomography.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2006; 116(6):645-53.
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ABSTRACT: The following review investigates the term and concept of the globulomaxillary cyst as a correct clinico-pathological diagnosis to describe a so-called fissural cyst said to be caused by epithelial entrapment between the nasal and maxillary process. After analyzing the available literature it has to be concluded that neither from an embryologic nor from a clinical or pathohistological standpoint the term globulomaxillary cyst represents a real entity by itself. Therefore, globulomaxillary cysts have to be diagnosed alternatively after a thorough clinical, radiological and histological examination as other odontogenic cysts like dentigerous cysts or odontogenic keratocysts, odontogenic tumors like ameloblastoma, central giant cell tumors, solitary bone cysts, etc.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2006; 116(4):380-97.
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ABSTRACT: Proliferative verrucous leukoplakia (PVL) is a seldom form of oral leukoplakia (OL) with high transformation tendency. It starts as a bold hyperkeratosis changing into an exophytic verrucous form spreading in the oral cavity. The clinical diagnosis therefore is a retrospective one.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2006; 116(5):508-20.
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ABSTRACT: A retrospective analysis of sinusfloor elevation and implantation should evaluate in a sense of quality control the clinical results and complications during or after sinusfloor elevation. In our institution we performed 98 sinusfloor elevations in 80 patients (44 women, 36 men) between August 9, 1995 and November 18, 2002. In those elevated sinuses, 201 implants were inserted till October 16, 2003. Dates were sampled from the patient medical histories. Sinusfloor elevation and implantation in posterior maxillary bone have a good prognosis. Nevertheless implant survival depended on the chosen implant system (Kaplan-Meier-analysis). Implant survival was 98% for Straumann implants and 80% for Frialit-II implants after two years. A significant correlation between Frialit-II implants and Straumann implants (p=0.0119) was identifiable. There was no difference in healing between different augmentation materials (autogenous bone, Ceros 82, Algipore), but case numbers were too small for a relevant validity. In one-stage procedures implant loss was 8%, in two-stage procedures it was 18%. Implant losses in smokers were generally higher than in non-smokers. The period of consolidation of the augmentation's material introduced in two-stage procedures was about 10.3 months, healing time of implants 9.2 months. In one-stage procedures healing time of implants was about 7.7 months. Membrane perforations during surgery occurred in 11% and were not related to the development of postoperative sinusitis as described in literature.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2006; 116(2):142-9.
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ABSTRACT: Using an endoscope in periradicular surgery provides an impressive optical enlargement and may lead to better clinical diagnostics and a high rate of success. Aims of this investigation were examining this hypothesis as well as detecting influencing factors. In 2002 and 2003, 114 teeth of 91 patients were root-end resected using endoscope. Before surgery, the tooth, number of resected root-ends, content of root channels, clinical diagnosis and moment of surgery were recorded. Patients were controlled one year after surgery and success was evaluated as a summary of clinical and radiological findings. Four patients did not reappear for the control examination. Out of 110 teeth, treatment was successful in 91.8% and failed in 7.3%. 0.9% could not be classified. Statistically, more failures were noted after periradicular surgery in molars. The rate of success increased during the study by means of a learning curve. The results confirm the hypothesis that where using an endoscope periradicular surgery is highly successful.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 01/2006; 116(1):12-7.
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ABSTRACT: The increasing number of high-risk patients in oral surgery makes it necessary to monitor the patient's general condition while operating. The surgeon needs a simple technical procedure to detect an impending clinical incident in time. From June 2002 to June 2004, 3012 patients underwent surgery in local anesthesia and were monitored with Colin BP 306 compact monitor. Heart rate, blood pressure, and oxygen saturation were checked non invasively during surgery. 17 times the operation was cancelled due to blood pressure problems. The treatment was cancelled twice due to cardiac arrhythmia. The average of the 19 patients' age was 63.5. Monitoring patients during surgery enables the surgeon to recognize high-risk situations immediately before the operation, to detect problem situations early and to avoid them, to work more calmly because of the enhanced security factor.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2005; 115(3):208-13.
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ABSTRACT: The odontogenic keratocyst is the third most common cyst of the jaws, after the follicular and radicular cyst. Keratocysts most commonly occur as single lesions in the jaw of otherwise healthy persons. Multiple odontogenic keratocysts are a well-recognized feature of the nevoid basal cell carcinoma syndrome. The mandible, especially the third molar region, the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. Clinically, the cysts often remain asymptomatic and there are two specific histological entities: the orthokeratinized and the parakeratinized odontogenic keratocyst. Different surgical treatment options like marsupialization, enucleation with curettage or peripheral ostectomy, and osseous resection (marginal or segmental) have been discussed in the literature with variable rates of recurrence. Besides a predilection for recurrence, the keratocysts, in contrast to other odontogenic cysts, show a more aggressive clinical behavior and demonstrate a high mitotic count and higher turnover rate of the epithelium. This led to the tentative suggestion that the keratocyst might be a benign cystic neoplasm rather than simply an odontogenic cyst.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2005; 115(2):110-28.
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ABSTRACT: Physicians, dentists and patients were questioned as to their knowledge of endocarditis prophylaxis. about three quarters of the physicians and about half of the dentists were able to judge the risk of endocarditis correctly. Removal of calculus was underestimated as a risk for bacteriemia by physicians and patients alike. dentists overestimated the risk for endocarditis in the group of "non-risk-patients" (bypass), a fact resulting in an overdose/overuse of antibiotics. patients with lower education had less knowledge about the relation between their own personal risk and the necessary dental treatment.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2005; 115(5):404-8.
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ABSTRACT: The rehabilitation of the chewing function of a patient is ultimately dependent on the quality and volume of the available jawbone. The vertical augmentation of the jawbone is often a challenge for the implanting dentist. Various methods, from transplanting autogenous bone through to the employment of bone substitute materials have been described and often controversially discussed. Vertical distraction offers an alternative to the pre-implantological augmentation of the vertically reduced bone. A technique which shows certain advantages over conventional augmentative methods.
Schweizer Monatsschrift für Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO 02/2005; 115(1):20-31.
