Chronic periodontitis and its possible association with oral squamous cell carcinoma – a retrospective case control study

Introduction: Different inflammatory processes may trigger the development of malignancies. Therefore, the aim of the present study was to evaluate a potential association between radiological determined chronic periodontitis (CPA) and oral squamous cell carcinoma (OSCC). Methods: In a retrospective study, OSCC-patients and a control group without malignant tumors were radiographically examined for bone loss. Via telephone survey and questionnaire, general clinical data on the individual oral hygiene and concomitant diseases together with tobacco and alcohol use were assessed and data were compared between the groups. Results: 178 OSCC-patients and 123 controls were included. In univariate analysis, a statistically relevant higher mean bone loss was seen in the OSCC group (4.3 mm (SD: 1.8; 95% confidence interval (CI): 4-4.6) vs. 2.9 mm (SD: 0.7; 95% CI: 2.8-3); p < 0.001)). This was confirmed in a multivariate regression model (OR: 2.4, 95% CI: 1.5-3.8; p < 0.001). A history of periodontal treatment was associated with significantly reduced OSCC risk (p < 0.001; OR: 0.2, CI: 0.1-0.5). Conclusions: CPA is a common disease and the monitoring as well as the treatment of such a chronic oral inflammation may be beneficial in reducing one potential cause of OSCC. Therefore, further clinical studies on oral neoplasms should consider clinical periodontal parameters as well

Antimicrobial Resistance and the Spectrum of Pathogens in Dental and Oral-Maxillofacial Infections in Hospitals and Dental Practices in Germany

Data on microbiological profiles in odontogenic infections are scarce. This study aimed to analyze the spectrum of pathogens and antimicrobial resistance in clinical isolates from dental and oral-maxillofacial clinical settings in Germany. We analyzed 20,645 clinical isolates (dental practices: n = 5,733; hospitals: n = 14,912) from patients with odontogenic infections using data (2012–2019) from the German Antimicrobial-Resistance-Surveillance (ARS) system. A total of 224 different species from 73 genera were found in clinical isolates from dental practices, and 329 different species from 97 genera were identified in isolates from hospital patients. In both hospitals and dental practices Streptococcus spp. (33 and 36%, respectively) and Staphylococcus spp. (21 and 12%, respectively) were the most frequently isolated microorganisms. In Streptococcus spp. isolates from hospitals, penicillin and aminopenicillin resistance proportions were 8.0% (95%CI 4.7–14.9%) and 6.9% (95%CI 4.7–9.9%), respectively. Substantially lower resistance proportions of penicillin and aminopenicillin were observed in dental practices [2.6% (95%CI 1.4–4.7%) and 2.1% (95%CI 1.1–4.0%), respectively]. Among Staphylococcus aureus isolates from hospital patients methicillin resistance proportions were 12.0% (95%CI 9.7–14.8%), which was higher than in isolates from dental practices (5.8% (95%CI 4.1–8.1%)]. High clindamycin and macrolide resistance proportions (>17%) were observed in Streptococcus spp. and Staphylococcus aureus isolates. In Klebsiella spp. isolates carbapenem resistance proportions were <1%. In sum, substantial antibiotic resistance was observed in isolates from odontogenic infections, which calls for strengthened efforts in antibiotic stewardship and infection prevention and control measures in both hospitals and dental practices.Peer Reviewe

Effectiveness of adjuvant radiotherapy in patients with oropharyngeal and floor of mouth squamous cell carcinoma and concomitant histological verification of singular ipsilateral cervical lymph node metastasis (pN1-state) - A prospective multicenter randomized controlled clinical trial using a comprehensive cohort design

<p>Abstract</p> <p>Background</p> <p>Modern radiotherapy plays an important role in therapy of advanced head and neck carcinomas. However, no clinical studies have been published addressing the effectiveness of postoperative radiotherapy in patients with small tumor (pT1, pT2) and concomitant ipsilateral metastasis of a single lymph node (pN1), which would provide a basis for a general treatment recommendation.</p> <p>Methods/Design</p> <p>The present study is a non-blinded, prospective, multi-center randomized controlled trial (RCT). As the primary clinical endpoint, overall-survival in patients receiving postoperative radiation therapy vs. patients without adjuvant therapy following curative intended surgery is compared. The aim of the study is to enroll 560 adult males and females for 1:1 randomization to one of the two treatment arms (irradiation/no irradiation). Since patients with small tumor (T1/T2) but singular lymph node metastasis are rare and the amount of patients consenting to randomization is not predictable in advance, all patients rejecting randomization will be treated as preferred and enrolled in a prospective observational study (comprehensive cohort design) after giving informed consent. This observational part of the trial will be performed with maximum consistency to the treatment and observation protocol of the RCT. Because the impact of patient preference for a certain treatment option is not calculable, parallel design of RCT and observational study may provide a maximum of evidence and efficacy for evaluation of treatment outcome. Secondary clinical endpoints are as follows: incidence and time to tumor relapse (locoregional relapse, lymph node involvement and distant metastatic spread), Quality of life as reported by EORTC (QLQ-C30 with H&N 35 module), and time from operation to orofacial rehabilitation. All tumors represent a homogeneous clinical state and therefore additional investigation of protein expression levels within resection specimen may serve for establishment of surrogate parameters of patient outcome.</p> <p>Conclusion</p> <p>The inherent challenges of a rare clinical condition (pN1) and two substantially different therapy arms would limit the practicality of a classical randomized study. The concept of a Comprehensive Cohort Design combines the preference of a randomized study, with the option of careful data interpretation within an observational study.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: NCT00964977</p

Kratki implantati nasuprot implantatima standardne dužine uz podizanje dna sinusa u slučaju atrofične stražnje maksile

Objectives: the aim of this clinical study was to compare clinical and radiological outcomes of short dental implants inserted in pristine bone to standard length implants inserted in combination with sinus floor elevation. Materials and methods: For this clinical study, the clinical and radiological outcome of 126 short dental implants (84 patients), inserted in pristine bone were compared with 312 standard length implants (156 patients), placed in combination with maxillary sinus floor elevation procedures. Results: The short implant group (test group [TG]; mean follow-up (± standard deviation (SD) 56.6 ± 42.9 months) and the augmented group (control group [CG]; mean follow-up 41.6 ± 37.6 months) showed cumulative survival rates of 91.8% and 92.4%. Cumulative 5-year implant survival rates were 91.8% for the TG and 90.7% for the CG (p=0.421). Mean marginal bone loss was significantly higher in the CG than in the TG, with a mean MBL of 0.70 ± 0.72 mm in the TG and 0.96 ± 0.91 mm in the CG (p<0.001). A comparable and promising oral health-related quality of life (OHRQoL) was observed in the control and test groups. Conclusions: After over 3 years, short implants placed in the resorbed posterior maxilla obtained similar results to standard implants combined with maxillary sinus floor augmentation procedures.Svrha rada: Uspoređivali su se klinički i radiološki rezultati kratkih dentalnih implantata ugrađenih u intaktnu kost s implantatima standardne dužine ugrađenima u kombinaciji s podizanjem dna sinusa. Materijal i metode: Za ovo kliničko istraživanje su klinički i radiološki ishodi 126 kratkih dentalnih implantata (84 pacijenta) ugrađenih u intaktnu kost uspoređeni s 312 implantata standardne dužine (156 pacijenata) usađenih u kombinaciji s postupcima podizanja dna maksilarnoga sinusa. Rezultati: Skupina s kratkim implantatima [testna skupina (TG); srednja vrijednost praćenja (± standardna devijacija (SD) 56,6 ± 42,9 mjeseci] i augmentirana skupina [kontrolna skupina (CG); srednja vrijednost praćenja 41,6 ± 37,6 mjeseci] pokazale su kumulativne stope preživljenja od 91,8 i 92,4 %. Kumulativne petogodišnje stope preživljenje implantata bile su 91,8 % za TG i 90,7 % za CG (p = 0,421). Prosječni marginalni gubitak kosti bio je značajno veći u CG-u nego u TG-u, uz srednji MBL od 0,70 ± 0,72 mm u TG-u i 0,96 ± 0,91 mm u CG-u (p < 0,001). I u kontrolnoj i u testnoj skupini uočena je usporediva i obećavajuća kvaliteta života povezana s oralnim zdravljem (OHRQoL). Zaključci: Nakon više od tri godine s kratkim implantatima ugrađenima u resorbiranu stražnju maksilu postignuti su slični rezultati kao i pri uporabi standardnih implantata u kombinaciji s postupcima podizanja dna maksilarnoga sinusa

Prevalence of Bisphosphonate Associated Osteonecrosis of the Jaws in Breast Cancer Patients

Svrha rada: Zadatak je bio ocijeniti tijekom sistematičnih oralnih pregleda prevalenciju nekroze kostiju povezanu s bisfosfanatima (BP-ONJ) i zaštitnim čimbenicima od razvoja BP-ONJ-a kod pacijentica s rakom dojke i koštanim metastazama pod terapijom bisfosfanatima. Ispitanici i metode: Na Odjelu ginekologije klinike u Mainzu (Njemačka) bila je provedena retrospektivna studija. Sudjelovale su sve pacijentice s rakom dojke (n=51) pod terapijom bisfosfanatima u razdoblju od srpnja 2006. do rujna 2007. Primarni kriterij bio je razvoj BP-ONJ-a i traženje mogućih dodatnih “okidača” za njegov razvoj te eventualni čimbenici za izbjegavanje. Rezultati: Samo kod jedne od 51 pacijentice razvio se BP-ONJ (2,0%). Pretpostavlja se da bi se kao dodatni “okidač” mogla identificirati ekstrakcija zuba. Stupanj oralne higijene tih pacijentica bio je iznad prosjeka. Zaključak: U usporedbi s ostalim malignim bolestima, BP-ONJ se kod pacijentica s rakom dojke ne javlja često. Primarna bolest mogla bi utjecati na njegov razvoj. Vjeruje se da bi dobra oralna higijena mogla biti zaštitni čimbenik.Objective: To evaluate the prevalence of Bisphosphonate-associated-osteonecrosis-of-the-jaws (BP-ONJ) and protective factors of BP-ONJ-development in breast cancer patients with osseous metastasis and bisphosphonate therapy using systematical dental oral examinations. Material and Methods: A cross-sectional-study was conducted in the Department for Gynecology in Mainz, Germany. All breast cancer patients (n=51) treated with bisphosphonate in the time span from 07/2006 to 09/2007 were recruited. Primary outcome was the development of BP-ONJ and the detection of possible additional trigger factors for the development of BP-ONJ, as well as possible factors for avoiding BP-ONJ. Results: Only 1 out of 51 patients developed BP-ONJ (2.0%). A tooth extraction could be identified as an additional trigger factor. The overall dental hygiene of this patient clientele was above average. Conclusion: Compared to other alignant diseases, BP-ONJ in breast cancer patients does not appear as often. The underlying disease might be of importance in the development of BP-ONJ. A good dental hygiene might be a protective factor

Modulation of Osteogenic Cell Morphology by ECM Ligands and Enamel Matrix Derivative

Preduvjet za uspješnu regeneraciju parodontnog tkiva jest odgovarajuća aktivacija populacije za to odgovornih stanica, poput osteoblasta. U tom su slučaju stanična adhezija i sazrijevanje usko povezani s morfologijom stanica i f-aktinskom organizacijom citoskeleta. Mogućnost pojačavanja parodontalnog cijeljenja pomoću pojedinih komponenti izvanstaničnog matriksa (ECM) i derivata caklinskog matriksa dobro je dokumentirana u literaturi. Svrha rada: Svrha ovog istraživanja bila je testirati učinak ECM-bjelančevina, kolagena tipa I, laminina-1 te komercijalnog proizvoda EMD-a na morfološku i citoskeletnu organizaciju osteogenih stanica. Ispitanici i postupci: Tijekom promatranja analizirano je ukupno 2450 osteogenih stanica iz pet različitih staničnih linija (četiri primarnih i jedne komercijalne) kultiviranih na pojedinim supstratima, a analizirali su ih tri neovisna promatrača. Nakon bojenja za f-aktin staničnog citoskeleta i automatizirane CLSM-vizualizacije, stanice su podijeljene u tri skupine ovisno o njihovim morfološkim svojstvima (nezrele, prijelazne i zrele). Osim deskriptivne analize obavljena je bila i multivarijantna logička regresija radi identificiranja odgovarajućih parametara koji utječu na staničnu morfologiju i organizaciju citoskeleta. Rabljeni pojedinačni ligandi kolagena i laminina te posebice EMD poticali su stvaranje zrelog osteogenog fenotipa, premda su bile uočene i određene razlike među korištenim staničnim linijama. Rezultati: Analiza morfologije i citoskeleta pouzdan je način skupljanja prvih podataka o biokompatibilnosti i bioaktivaciji stanica na različitim supstratima. Naši rezultati upućuju na mogući potencijal istraživanih liganada u pojačavanju osteogenoga staničnog pričvrstka i sazrijevanju te time i pomaganju cijeljenja parodontnog tkiva.The precondition for successful periodontal regeneration is adequate activation of relevant cell populations like osteogenic cells. Here, cell adhesion and maturation are closely associated with cell morphology and f-actin cytoskeletal organisation. The potential of solitaire extracellular matrix (ECM) components as well as enamel matrix derivative (EMD) to enhance periodontal healing is well documented. Objective: The aim of the study was to test the impact of the ECM proteins collagen type 1 and laminin-1 as well as commercially available EMD on osteogenic cell morphology and cytoskeletal organisation. Material and methods: In an observational study, a total of 2450 osteogenic cells of 5 different cell lines (4 primary ones and 1 commercial one) cultivated on the respective substrates were analysed by 3 independent observers. After staining for the f-actin cytoskeleton and automated CLSM visualisation, cells were assigned to 3 different categories depending on morphological cell attributes (immature vs. intermediate vs. mature). Besides descriptive analysis, a multivariate logistic regression was performed to identify relevant influence parameters on cell morphology and cytoskeletal organisation. Results: The applied solitaire ligands collagen and laminin and especially EMD promoted a mature osteogenic phenotype. Nevertheless, considerable differences between the investigated cell lines could be identified as well. Analysis of cell morphology and cytoskeletal organisation offers a reliable method of acquiring the first hints of biocompatibility and bio-activation on different substrates. Conclusion: Our results highlight the potential of the investigated ligands to support periodontal regeneration by enhancing osteogenic cell attachment and maturation

SARS-CoV-2 Vaccination Rate and SARS-CoV-2 Infection of Health Care Workers in Aerosol-Generating Medical Disciplines

Healthcare workers (HCW) who perform aerosol-generating procedures (AGP) are at high risk of SARS-CoV-2 infection. Data on infection rates and vaccination are limited. A nationwide, cross-sectional study focusing on AGP-related specialties was conducted between 3 May 2021 and 14 June 2021. Vaccination rates among HCW, perception of infection risk, and infection rates were analyzed, focusing on the comparison of gastrointestinal endoscopy (GIE) and other AGP-related specialties (NON-GIE), from the beginning of the pandemic until the time point of the study. Infections rates among HCW developed similarly to the general population during the course of the pandemic, however, with significantly higher infections rates among the GIE specialty. The perceived risk of infection was distributed similarly among HCW in GIE and NON-GIE (91.7%, CI: 88.6–94.4 vs. 85.8%, CI: 82.4–89.0; p < 0.01) with strongest perceived threats posed by AGPs (90.8%) and close patient contact (70.1%). The very high vaccination rate (100–80%) among physicians was reported at 83.5%, being significantly more frequently reported than among nurses (56.4%, p < 0.01). GIE had more often stated very high vaccination rate compared with NON-GIE (76.1% vs. 65.3%, p < 0.01). A significantly higher rate of GIE was reported to have fewer concerns regarding infection risk after vaccination than NON-GIE (92.0% vs. 80.3%, p < 0.01)

SARS-CoV-2 vaccination rate and SARS-CoV-2 infection of health care workers in aerosol-generating medical disciplines

Healthcare workers (HCW) who perform aerosol-generating procedures (AGP) are at high risk of SARS-CoV-2 infection. Data on infection rates and vaccination are limited. A nationwide, cross-sectional study focusing on AGP-related specialties was conducted between 3 May 2021 and 14 June 2021. Vaccination rates among HCW, perception of infection risk, and infection rates were analyzed, focusing on the comparison of gastrointestinal endoscopy (GIE) and other AGP-related specialties (NON-GIE), from the beginning of the pandemic until the time point of the study. Infections rates among HCW developed similarly to the general population during the course of the pandemic, however, with significantly higher infections rates among the GIE specialty. The perceived risk of infection was distributed similarly among HCW in GIE and NON-GIE (91.7%, CI: 88.6–94.4 vs. 85.8%, CI: 82.4–89.0; p < 0.01) with strongest perceived threats posed by AGPs (90.8%) and close patient contact (70.1%). The very high vaccination rate (100–80%) among physicians was reported at 83.5%, being significantly more frequently reported than among nurses (56.4%, p < 0.01). GIE had more often stated very high vaccination rate compared with NON-GIE (76.1% vs. 65.3%, p < 0.01). A significantly higher rate of GIE was reported to have fewer concerns regarding infection risk after vaccination than NON-GIE (92.0% vs. 80.3%, p < 0.01)

The influence of saliva pH value on the retention and durability of bar-clip attachments

The aim of this study was to compare the durability and retention of 4 types of attachments placed over computer aided design/computer aided manufacturing (CAD/CAM) titanium bars when subjected to different pH conditions. MATERIALS AND METHODS. Four commercially available attachments were investigated: Hader Yellow, Hader Red, Ackerman Gold and Ackerman Stainless Steel. These attachments and Ackerman CAD/CAM titanium bars were placed in 2 vessels containing different artificial saliva solutions (pH 7/ pH 4) at 37 degrees C for one month to simulate corrosion conditions, and they were then subjected to mechanical testing (5400 cycles of insertion and removal). RESULTS. The results revealed that there were significant differences in the average values of insertion/removal force due to the pH (F (1, 24)=9.207, P<9.05) and the type of attachment (F (3, 24)=11.742, P<.05). CONCLUSION. More acidic pH values were found to have a negative influence on the retention capacity of the attachments.info:eu-repo/semantics/publishedVersio