Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study

BACKGROUND: Fibro-osseous lesions (FOL) of the jaw represent a rare, benign group of lesions that share similar clinical, radiological, and histopathological features and are characterized by progressive, variable replacement of healthy bone tissue by fibrous connective tissue. METHODS: This retrospective study aimed to evaluate the incidence of fibro-osseous lesions and to reassess the efficacy of case-specific treatment management from a clinical, radiological, and histopathological perspective based on 14 years of data. RESULTS: Forty-four patients with a radiological and/or histopathological diagnosis of benign FOLs were identified and re-evaluated. Cemento-osseous dysplasia was the most common group of FOLs present in our patient cohort (45%), followed by ossifying fibroma (39%) and fibrous dysplasia (16%). The diagnostic imaging technique of choice was CBCT (68%), followed by PAN (18%), with most patients (95 %) additionally undergoing biopsy. The mean age of the patients at the time of diagnosis was 40.54 ± 13.7 years, with most lesions being located in the mandible (86%), with females being predominantly affected (73%). CONCLUSION: An interdisciplinary approach that analyzes all case-specific factors, including demographic data, medical history, intraoperative findings, and, most importantly, histopathological and radiological features, is essential for an accurate diagnosis and key to avoiding inappropriate treatment

Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation

The following work is the first evaluating the applicability of 3D printed zirconium dioxide ceramic miniplates and screws to stabilize maxillary segments following a Le-Fort I advancement surgery. Conventionally used titanium and individual fabricated zirconium dioxide miniplates were biomechanically tested and compared under an occlusal load of 120N and 500N using 3D finite element analysis. The overall model consisted of 295,477 elements. Under an occlusal load of 500N a safety factor before plastic deformation respectively crack of 2.13 for zirconium dioxide and 4.51 for titanium miniplates has been calculated. From a biomechanical point of view 3D printed ZrO2 mini-plates and screws are suggested to constitute an appropriate patient specific and metal-free solution for maxillary stabilization after Le Fort I osteotomy

Identification of Functionally Distinct Na-HCO3 Co-Transporters in Colon

Na-HCO3 cotransport (NBC) regulates intracellular pH (pHi) and HCO3 secretion in rat colon. NBC has been characterized as a 5,5′-diisothiocyanato-2-2′-stilbene (DIDS)-sensitive transporter in several tissues, while the colonic NBC is sensitive to both amiloride and DIDS. In addition, the colonic NBC has been identified as critical for pHi regulation as it is activated by intravesicular acid pH. Molecular studies have identified several characteristically distinct NBC isoforms [i.e. electrogenic (NBCe) and electroneutral (NBCn)] that exhibit tissue specific expression. This study was initiated to establish the molecular identity and specific function of NBC isoforms in rat colon. Northern blot and reverse transcriptase PCR (RT-PCR) analyses revealed that electrogenic NBCe1B or NBCe1C (NBCe1B/C) isoform is predominantly expressed in proximal colon, while electroneutral NBCn1C or NBCn1D (NBCn1C/D) is expressed in both proximal and distal colon. Functional analyses revealed that amiloride-insensitive, electrogenic, pH gradient-dependent NBC activity is present only in basolateral membranes of proximal colon. In contrast, amiloride-sensitive, electroneutral, [H+]-dependent NBC activity is present in both proximal and distal colon. Both electrogenic and electroneutral NBC activities are saturable processes with an apparent Km for Na of 7.3 and 4.3 mM, respectively; and are DIDS-sensitive with apparent Ki of 8.9 and 263.8 µM, respectively. In addition to Na-H exchanger isoform-1 (NHE1), pHi acidification is regulated by a HCO3-dependent mechanism that is HOE694-insensitive in colonic crypt glands. We conclude from these data that electroneutral, amiloride-sensitive NBC is encoded by NBCn1C/D and is present in both proximal and distal colon, while NBCe1B/C encodes electrogenic, amiloride-insensitive Na-HCO3 cotransport in proximal colon. We also conclude that NBCn1C/D regulates HCO3-dependent HOE694-insensitive Na-HCO3 cotransport and plays a critical role in pHi regulation in colonic epithelial cells

Development of Smart Apartments in Austria - Importance and Design in Today's World

Abweichender Titel nach Übersetzung der Verfasserin/des VerfassersIm Wandel der Zeit stellt sich die Frage, wie sich der Wohnraum bzw. die Wohnraumsituation entwickeln wird, welchen Einfluss die Mietpreisentwicklung und neue Technologien auf die aktuelle Wohnsituation haben oder ob eine „neue“ Form des Wohnens Einzug finden wird. Um den Zuzug in Ballungsräumen bewerkstelligen zu können, stehen Wohnkonzepte im Zentrum, die den zukünftigen Herausforderungen standhalten können und gewachsen sind. Tatsächlich ist die Diskussion rund um das Thema modernes Wohnen gerechtfertigt. Der Trend der Urbanisierung wird immer stärker. Unterstellt man hierbei die Neoklassische Preistheorie (Allgemeine Gleichgewichtstheorie) der Wirtschaftswissenschaften, welche die klassische Wertund Preistheorie um subjektive Kosten ergänzt, kommt man, besonders in Wien, schnell zu dem Ergebnis, dass beim Thema Wohnen die Nachfrage gegenüber dem Angebot in gewissen Preissegmenten überwiegt. Dies führt in weiterer Folge zu steigenden Immobilien-/ Mietpreisen. Diese Trends haben in weiterer Folge Auswirkungen auf die Bevölkerung und sämtliche Branchen, die direkt oder indirekt mit dem Thema Wohnen einen Zusammenhang haben. Hierbei kommt „Smart Wohnen“ bzw. „Smart Living“ ins Spiel. Nach dem Wiener Wohnbaustadtrat Michael Ludwig lässt sich eine Smart Wohnung als komplett, kompakt und kostengünstig definieren. In der vorliegenden Arbeit wird eine genaue Begriffsabgrenzung bzw. Definition ausgeführt werden, da der Begriff „Smart Wohnen“ von moderner Wohnraumgestaltung bis zur Implementierung von High-End-Technik reicht und dies in weiterer Folge den Rahmen der Arbeit sprengen würde. Ziel der Arbeit ist es, zu untersuchen wie, wo und in welcher Wohnform die zukunftsorientierte Wohnlösung von Morgen aussieht bzw. liegt. Unter "Smart Wohnen" werden hierbei moderne, nutzungsneutrale Wohnformen mit optimalen Grundrissen und optimierter Flächennutzung definiert. Dabei wird erörtert, welche Bedeutung "Smart Wohnen" bereits im deutschsprachigen Raum (Schwerpunkt Österreich) hat und in Zukunft haben wird. Dies wird anhand von Praxisbeispielen untermauert. In diesem Zusammenhang werden die Form und auch der Standort von "Smart Wohneinheiten" diskutiert und abschließend die optimale Ausgestaltung analysiert und näher betrachtet. Daraus ergeben sich zentrale Inhalte, die näher betrachtet werden müssen. Beispielsweise konnte man in der jüngeren Vergangenheit beobachten, dass "Smart Wohnen" vor allem im Bereich von studentischem Wohnen ein exponentielles Wachstum verzeichnete, fraglich ist hierbei, ob diese moderne Wohnform auch bei der breiten Bevölkerungsmasse Einzug finden wird. Die Arbeit soll einen Mehrwert für jeden am Immobilienmarkt interessierten Adressaten liefern und ihn eventuell bei einer künftigen Investitionsentscheidung unterstützen.9

Radiologic, functional and esthetic evaluation of anterior maxilla single tooth implants following socket augmentation surgery

Einleitung Der implantologische Ersatz eines verlorengegangenen Zahnes in der ästhetischen Zone des Oberkiefers, stellt oft eine große Herausforderung dar. Die physiologischen Veränderungen des Weich- sowie Hartgewebes, nach einem Zahnverlust, erschweren es häufig, funktionell aber auch ästhetisch zufriedenstellende implantologische Restaurationen zu etablieren. Aus diesem Grund wurden chirurgische Techniken entwickelt die diesen physiologischen Prozessen entgegenwirken sollten. Eine häufig angewandte Methode ist die "Socket bzw. Ridge Preservation". Darunter versteht man im Allgemeinen die präimplantologische Auffüllung einer Extraktionsalveole mit Knochenersatzmaterial, um die natürlichen Resorptionsvorgänge zu minimieren. Dabei kann im Durchschnitt um 1mm, sowohl in horizontaler als auch in vertikaler Richtung, mehr Knochen erhalten werden. Mehrere Studien haben radiologische sowie klinische Erfolge der Socket Preservation untersucht, jedoch wurde bis dato noch keine Studie veröffentlicht, die die ästhetischen Ergebnisse von implantologischen Restaurationen nach Socket Preservation evaluiert. Demnach analysiert diese Studie erstmals die radiologischen, klinischen sowie auch die ästhetischen Ergebnisse von implantologischen Versorgungen nach Socket Preservation im Oberkiefer Frontzahnbereich. Material und Methoden Radiologische sowie klinische Daten wurden von 25 Patienten erhoben, 24 Patienten wurden zusätzlich nach ästhetischen Kriterien beurteilt. Radiologisch wurde der Knochenverlust um das Implantat ("marginal bone loss" (MBL)) sowohl mesial als auch distal berechnet. Klinisch wurden die Patientendaten systematisch nach Implantatverlusten, Komplikationen sowie den Sondierungswerten an sechs Stellen des Implantates gescreent. Um eine objektive ästhetische Evaluation zu ermöglichen wurden der Pink Esthetic Score (PES) sowie der Papilla Index (PI) anhand von standardisierten Photographien ausgewertet. Der mittlere Nachuntersuchungszeitraum betrug für die radiologischen sowie klinischen Parameter 1,3 Jahre (SD: 0,6), für ästhetische 1,2 Jahre (SD: 0,6). Ergebnisse Die prä-, peri- und post-implantologischen Behandlungen verliefen bei allen Patienten ohne Komplikationen. Die durchschnittliche klinische Sondierungstiefe rund um die Implantate betrug 1,821mm (SD: 0,25mm). Radiologisch wurde ein durchschnittlicher peri-implantologische Knochenabbau von 1,16mm (SD: 0,16 mm) gemessen, wobei kein signifikanter Unterschied zwischen der mesialen 1,27mm (SD: 0,25mm) und der distalen (Mean SEM =1,05 0,14mm) Abbaurate bestand. Ästhetisch wurden 71% der Patienten mit einem Pink Esthetic Score (PES) von mindestens 10 Punkten und 29% mit einem PES von maximal 9 Punkten bewertet. 75% der mesialen und 79% der distalen Papillen wurden mit einem Papilla Index (PI) von 3 bewertet, da die Papillen den gesamten Approximalraum, auffüllten und sich harmonisch eingliederten. Zusammenfassung In prä-implantologischen Situationen mit unvollständig erhaltener bukkaler Lamelle, ist die Socket Preservation Therapie eine geeignete Methode um sowohl ästhetisch als auch funktionell zufriedenstellende Ergebnisse zu erzielen.Introduction The restoration of a tooth in the anterior maxilla is an awkward task for clinicians as the outcome especially in this region crucially depends on esthetic parameters. Physiological loss of soft and hard tissue structures following every tooth extraction often prevents to establish functionally and esthetically satisfactory implant supported restorations. As a consequence surgical techniques have been introduced trying to prevent excessive loss of bone and in consequence soft tissue architecture. One method well known as socket or ridge preservation generally means the padding of a fresh extraction socket with bone substitutes to reduce the extent of resorption. Systematic reviews have shown that socket/ridge preservation procedures increase available bone by 1 mm both in vertical as well as in horizontal dimension, on average. Although many studies have already analyzed clinical and radiographic parameters following socket preservation, no study exists that evaluates the esthetics of implant supported restorations following socket preservation. Therefore this study evaluates outcome of dental implants following socket preservation concerning clinical, radiographic and esthetic parameters. Methods Radiological/clinical data of 25 patients was analyzed and esthetic evaluation of 24 patients was performed. By use of the radiological images the peri-implant marginal bone loss (MBL) was measured at both the distal as well as at the mesial side. Clinically, patients' records were systematically screened for implant loss and side events swaying the clinical outcome and measurement of peri-implant probing depths at six sites was performed. The Pink Esthetic Score (PES) as well as the Papilla Index (PI) served to objectify esthetic outcomes based on standardized photographs of the restorations. The mean follow-up time for clinical and radiographic analysis was 1.3 years (SD: 0.6 years) and 1.2 years (SD: 0.6) for esthetic evaluation. Results In all cases the socket preservation surgery, the consecutive implant placement surgery and the prosthetic restoration have occurred uneventful. The mean probing depth around all implants was 1.821mm (SD: 0.25mm). The radiological measured mean peri-implant marginal bone loss was 1.16mm (SD: 0.16 mm), showing no significant difference betweeneingereicht von Lukas Mathias HingsammerAbweichender Titel laut Übersetzung der Verfasserin/des VerfassersWien, Med. Univ., Dipl.-Arb., 2015(VLID)171617

The influence of crown-to-implant ratio on marginal bone levels around splinted short dental implants: A radiological and clincial short term analysis

BACKGROUND The amount of marginal bone resorption around dental implants is considered to have a significant impact on implant stability as well as implant survival rates. PURPOSE The aim of this prospective study was to investigate the influence of prosthetic as well as patient specific factors on marginal bone loss around short dental implants. MATERIALS AND METHODS Seventy-six implants, which supported splinted crowns were included for investigation. All implants were from the same type and had an intraosseous length of 6.5 mm and a diameter of 4.0 mm. Twenty implants were additionally splinted onto longer ones. Measurements of marginal bone loss were performed at a mean of 12.38 months after prosthetic loading and the mean follow-up for clinical evaluation was 20.52 months. RESULTS Overall two implant failures were recorded, revealing a survival rate of 97.3%. Marginal bone resorption around 72 short implants measured 0.71 mm (SD: 0.74 mm) and was found to have a strong correlation with calculated Crown-to-Implant ratio (r = .71; P < .001). Age, gender, insertion torque, implant surface area, location, position, bone quality, and insertion torque did not influence peri-implant bone loss after one year of loading. CONCLUSION Within the limitations of the study, it is suggested that Crown-to-Implant ratios should not exceed 1.7 to avoid increased early marginal bone loss

Is acetabular osteoplasty always required in mixed impingement?

Background Mixed femoroacetabular impingement (FAI) is typically managed with both femoral and acetabular rim osteoplasties, but it has not been reported if the rim osteoplasty is always required. Hypothesis/purpose We hypothesized that mixed FAI managed by femoral or combined femoral and acetabular osteoplasties will both attain satisfactory clinical results, provided intraoperative impingement-free functional motion is attained. Methods We retrospectively reviewed 30 hips (23 patients, mean age at surgery 24.3 years, mean follow-up time 1.6 years) with mixed FAI who underwent surgical dislocation of the hip and had femoral osteochondroplasty with rim trim (RT, n = 21) or no rim trim (NRT, n = 9). Physical examination results and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores were evaluated. Results Mean (±SD) WOMAC pain scores improved from 6.56 (±2.96) to 2.33 (±3.64) in the NRT group (p = .002) and from 6.86 (±4.15) to 3.86 (±3.95) in the RT group (p = .014). Function improved in both groups, but the difference was significant only for the NRT group (p < .001). Over 50 % of patients in both groups had resolution of impingement sign. Internal rotation increased from 8.6° (±11.8) to 20.0° (±10.4) in the NRT group (p = .043) and from 4.0° (±12.1) to 18.6° (±14.0) in the RT group (p < .001). Both groups had increased flexion post-operatively to normal range, but the change was only significant for the RT group (p = .02). Both groups had insignificant decreases in external rotation. Conclusion Satisfactory clinical outcomes were seen in hips with mixed impingement, regardless of whether RT was performed, provided impingement-free functional motion was attained and no severe cartilage damage was seen

Postoperative alignment of TKA in patients with severe preoperative varus or valgus deformity: is there a difference between surgical techniques?

Abstract Background There have been conflicting studies published regarding the ability of various total knee arthroplasty (TKA) techniques to correct preoperative deformity. The purpose of this study was to compare the postoperative radiographic alignment in patients with severe preoperative coronal deformity (≥10° varus/valgus) who underwent three different TKA techniques; manual instrumentation (MAN), computer navigated instrumentation (NAV) and patient specific instrumentation (PSI). Methods Patients, who received a TKA with a preoperative coronal deformity of ≥10° with available radiographs were included in this retrospective study. The groups were: MAN; n = 54, NAV; n = 52 and PSI; n = 53. The mechanical axis (varus / valgus) and the posterior tibial slope were measured and analysed using standing long leg- and lateral radiographs. Results The overall mean postoperative varus / valgus deformity was 2.8° (range, 0 to 9.9; SD 2.3) and 2.5° (range, 0 to 14.7; SD 2.3), respectively. The overall outliers (>3°) represented 30.2% (48 /159) of cases and were distributed as followed: MAN group: 31.5%, NAV group: 34.6%, PSI group: 24.4%. No significant statistical differences were found between these groups. The distribution of the severe outliers (>5°) was 14.8% in the MAN group, 23% in the NAV group and 5.6% in the PSI group. The PSI group had significantly (p = 0.0108) fewer severe outliers compared to the NAV group while all other pairs were not statistically significant. Conclusions In severe varus / valgus deformity the three surgical techniques demonstrated similar postoperative radiographic alignment. However, in reducing severe outliers (> 5°) and in achieving the planned posterior tibial slope the PSI technique for TKA may be superior to computer navigation and the conventional technique. Further prospective studies are needed to determine which technique is the best regarding reducing outliers in patients with severe preoperative coronal deformity

Three-dimensional corrective osteotomies of mal-united clavicles-is the contralateral anatomy a reliable template for reconstruction?

In computer-assisted preoperative planning of corrective osteotomies, the unaffected contralateral bone often serves as three-dimensional template for the reconstruction of mal-united bones. Before applying this approach to new anatomy such as the clavicle bone, it is important to study asymmetry between the sides. The purpose of this study was to investigate bilateral symmetry of the clavicle in healthy cadavers using three-dimensional measurement techniques. Bilateral symmetry of 102 clavicles (51 cadavers, mean age: 52.19 years, 37 male) was measured based on three-dimensional models reconstructed from computed tomography. Besides length, volume, and surface, the side-differences were evaluated by considering the mirrored left clavicle as the reconstruction template and the right clavicle as the one that will be realigned by osteotomy. The relative transformation between the aligned segments was measured to express the difference with to three-dimensional translation and rotation. The same procedure was repeated using mean-sized clavicles, one for each gender, as the template. The contralateral side was a significant more accurate reconstruction template compared to a mean-sized clavicle (P < 0.001). Nevertheless, an average side-differences with respect to rotation and translation of 8.79° ± 5.2° and 3.5 mm ± 2.7 mm, respectively. The left clavicles were significant (P = 0.001) longer with 154 mm compared to the right ones (151 mm). Three-dimensional differences between the left and right clavicles exist, but can be considered as small. Therefore, the contralateral side appears to be a reliable reconstruction template, in particular compared to a mean-sized clavicle. Clin. Anat. 28:865-871, 2015. © 2015 Wiley Periodicals, Inc