Prevalence of dental caries in children with congenital heart disease

Background: Congenital heart defects (CHD) affect about 8 out of 1000 births worldwide. Most of the patients reach adulthood and are exposed to an increased risk of endocarditis. Since bacteria already enter the bloodstream during everyday activities, oral hygiene is given special importance in the prevention of endocarditis. Methods: In this study 81 boys (55.1%) and 66 (44.9%) girls with CHD received a dental exam and additionally an assessment using the DIAGNOdent (R) pen. This study group consisting of patients with CHD was matched with a healthy epidemiological control group in Germany. Results: Eighty-one boys (55.1%) and 66 (44.9%) girls were examined. The mean age was 11 & PLUSMN; 4 years. 38.8% showed at least one untreated carious lesions. 37.4% had a dmft/DMFT & GE;2 and thus represented a group with an increased caries risk. The dmft value was 2.12 & PLUSMN; 1.25 in the age group 3-6 year olds. In the group of the 7-12 year old patients the DMFT/dmft was 2.06 & PLUSMN; 2.27, whereas DMFT in 13-17 year olds was at 2.12 & PLUSMN; 1.58. However, children and adolescents with CHD had a higher DMF index than healthy children in the same age group. Conclusions: The present study reveals that more than one third of those examined have a dental condition in need of rehabilitation. In future, close interdisciplinary cooperation between pediatric cardiologists and dentists should ensure regular dental check-ups

Oral bacteria in infective endocarditis requiring surgery: a retrospective analysis of 134 patients.

OBJECTIVES It has been reported that bacteria associated with infective endocarditis originate from the oral cavity in 26-45% of cases. However, little is known on the counts and species of periodontal microbiota in infected heart valves. The aim of this study was to identify these aspects of periodontal microbiota in infective endocarditis and to potentially initiate a dental extraction concept for periodontally compromised teeth concerning patients requiring heart valve surgery. MATERIALS AND METHODS The retrospective study group consisted of tissue samples from infected heart valves of 683 patients who had undergone heart valve surgery. Before patients had undergone cardiac surgery, the following laboratory tests confirmed the occurrence of endocarditis in all patients: blood cultures, echocardiography, electrocardiography, chest X-ray, and electrophoresis of the serum proteins. The specimens were aseptically obtained and deep frozen immediately following surgery. Microbiological diagnosis included proof of germs (dichotomous), species of germs, and source of germs (oral versus other). RESULTS Microbiota was detected in 134 (31.2%) out of 430 enrolled patients. Oral cavity was supposed to be the source in 10.4% of cases, whereas microbiota of the skin (57.5%) and gastrointestinal tract (GIT, 24.6%) were detected considerably more frequently. Moreover, periodontal bacteria belonged mostly to the Streptococci species and the yellow complex. None of the detected bacteria belonged to the red complex. CONCLUSION Most frequently, the skin and GIT represented the site of origin of the microbiota. Nevertheless, the oral cavity represented the source of IE in up to 10%. Consequently, it needs to be emphasized that a good level of oral hygiene is strongly recommended in all patients undergoing heart valve surgery in order to reduce the bacterial load in the oral cavity, thereby minimizing the hematogenous spread of oral microbiota. The prerequisites for conservative dental treatment versus radical tooth extraction must always be based on the patient's cooperation, and the clinical intraoral status on a sense of proportion in view of the overall clinical situation due to the underlying cardiac disease. CLINICAL RELEVANCE The oral cavity is a source of oral microbiota on infected heart valves. Patients requiring heart valve surgery should always undergo a critical evaluation of dental treatment affecting periodontally compromised teeth, favoring a systematic, conservative-leaning recall

«Diseño para todos» en la investigación social sobre personas con discapacidad

[EN] Social studies on disability have increased in number and importance in Spain and other countries over the last few years. Nevertheless, the majority of the available sources and studies do not adequately represent this heterogeneous group, which currently makes up about 9 per cent of the Spanish population. The implementation of social measures requires representative sources and studies containing relevant information. The aim of this paper is to identify the main diffi culties involved in designing and developing social research methods concerning persons with disabilities, and offer proposals and recommendations in order to advance towards a more inclusive social research using the concepts of accessibility and design for all.[ES] Los estudios sociales sobre la discapacidad han aumentado en número e importancia en España y otros países durante los últimos años. Sin embargo, la mayoría de fuentes de información y estudios disponibles no recogen de manera adecuada la realidad de un colectivo muy heterogéneo, que supone en la actualidad aproximadamente el 9 por ciento de la población española. La implementación de medidas sociales requiere de fuentes y estudios representativos que aporten información precisa acerca de estas personas. El objetivo de esta nota es identifi car las principales difi cultades que se plantean a la hora de diseñar y llevar a la práctica metodologías de investigación social adecuadas hacia las personas con discapacidad, así como ofrecer propuestas y recomendaciones para avanzar hacia una investigación social más inclusiva, mediante los conceptos de accesibilidad y diseño para todos.Work carried out as part of the framework of research projects: “Qualitative Tracking with Young Disabled in European States. Quali-TYDES” (European Science Foundation, 09-ECRP-032) and “Hidden Innovation: paradigm shift in innovation studies” (Spanish Ministry of Economy and Competitiveness, FFI2011-25475).Peer reviewe

Oral rehabilitation and associated quality of life following mandibular reconstruction with free fibula flap: a cross-sectional study

IntroductionMandibular reconstruction with the free fibula flap (FFF) has become a standardized procedure. The situation is different with oral rehabilitation, so the purpose of this study was to investigate the frequency of implant placement and prosthetic restoration. Additionally, the patients’ situation, motivation, and treatment course were structurally assessed.Materials and methodsAll cases between January 2013 and December 2018 that underwent mandibular reconstruction in our department with a free fibula flap and gave written informed consent to participate were interviewed with two structured questionnaires about their restoration and quality of life. Additionally, medical records, general information, status of implants and therapy, and metric analyses of the inserted implants were performed.ResultsIn total 59 patients were enrolled and analyzed in this monocentric study. Overall, oral rehabilitation was achieved in 23.7% at the time of investigation. In detail, implants were inserted in 37.3% of patients and showed an 83.3% survival of dental implants. Of these implanted patients, dental implants were successfully restored with a prosthetic restoration in 63.6. Within this subgroup, satisfaction with the postoperative aesthetic and functional result was 79.9% and with the oral rehabilitation process was 68.2%. Satisfaction with the implant-borne prosthesis was 87.5%, with non-oral-squamous-cell-carcinoma patients being statistically significantly more content with the handling (p=0.046) and care (p=0.031) of the prosthesis.DiscussionDespite the well-reconstructed bony structures, there is a need to increase the effort of achieving oral rehabilitation, especially looking at the patient’s persistent motivation for the procedure

Herkules – Held zwischen Tugend und Hybris. Ein europäischer Erinnerungsort der Frühen Neuzeit?

This essay traces some of the contexts and media in which "Heracles-Hercules" - as a hero between virtue and hubris - was visible in European societies from the end of the middle ages onwards. It discusses whether this example of the reception, appropriation and transformation of classical myths in the early modern period can be understood as a European "lieu de mémoire", and to what extent the concept of "lieux de mémoire" (or sites of memory) can foster our understanding of a particular object of study (here the Heracles/Hercules myth). Against this backdrop, we conclude with some general questions about the more ambitious project* of a comprehensive register of European "lieux de mémoire". * * Published as: Boer, Pim den / Duchhardt, Heinz / Kreis, Georg / Schmale, Wolfgang (eds.): Europäische Erinnerungsorte, 3 vols., Munich 2011–201

On-Chip Integration of Functional Hybrid Materials and Components in Nanophotonics and Optoelectronics

[No abstract available

Are selected IL-1 polymorphisms and selected subgingival microorganisms significantly associated to periodontitis in type 2 diabetes patients? a clinical study.

We evaluated the periodontal conditions in patients with type 2 diabetes mellitus compared to metabolically healthy controls, and determined whether periodontal interleukin genotypes and microorganisms differed between participants with and without type 2 diabetes mellitus.From April 2011 to July 2012, we prospectively enrolled healthy controls and patients with type 2 diabetes mellitus. Evaluation included assessment of medical and periodontal findings. We also recorded the presence of several interleukin gene variants and specific microorganisms, both available through commercially available diagnostic kits. Statistical significance was tested by the chi-square test and student's t-test.We enrolled 52 patients with type 2 diabetes mellitus and 52 healthy controls. Compared with controls, periodontal disease was significantly more severe in patients with type 2 diabetes mellitus for the following: plaque index, bleeding on probing, pocket probing depth, clinical attachment loss, severe periodontal destruction (i.e., clinical attachment loss >= 5 mm), and number of teeth. However, statistical analysis failed to detect significant differences with respect to the periodontal-related interleukin genotypes (p >= 0.58) or the selected oral microbiota (p >= 0.15).Based on these results, it may be assumed that chronic periodontitis in patients with type 2 diabetes mellitus is most strongly associated with inadequate oral hygiene. Periodontal interleukin genotypes and differences in oral microbiota seem to play a subordinate role

Nonsurgical antimicrobial photodynamic therapy in moderate vs severe peri-implant defects: a clinical pilot study.

Recent review articles have shown that open debridement is more effective in the treatment of peri-implantitis than closed therapy. However, surgery may result in marginal recession and compromise esthetics. The purpose of this study was to assess the efficacy of nonsurgical antimicrobial photodynamic therapy (aPDT) in moderate vs severe defects.The study encompassed 16 patients with a total of 18 ailing implants. Ten of these implants showed moderate bone loss (< 5 mm; Group 1) and eight implants severe defects (5 through 8 mm; Group 2). All implants received aPDT without surgical intervention. At baseline and 2 weeks, 3 months, and 6 months after therapy, peri-implant health was assessed including sulcus bleeding index (SBI), probing depth (PD), distance from implant shoulder to marginal mucosa (DIM), and clinical attachment level (CAL). Radiographic evaluation of distance from implant to bone (DIB) allowed comparison of peri-implant hard tissues after 6 months.Baseline values for SBI were comparable in both groups. Three months after therapy, in both groups, SBI and CAL decreased significantly. In contrast, after 6 months, CAL and DIB increased significantly in Group 2, not in Group 1. However, DIM-values were not statistically different 6 months after therapy in both groups.Within the limits of this 6-month study, nonsurgical aPDT could stop bone resorption in moderate peri-implant defects but not in severe defects. However, marginal tissue recession was not significantly different in both groups at the end of the study. Therefore, especially in esthetically important sites, surgical treatment of severe peri-implantitis defects seems to remain mandatory