Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Bollard coping as an attachment for implant-supported dentures

The Bollard coping has been employed as an attachment for implant-supported dentures for more than 15 years. After the conclusion of a preliminary study reporting 3-year results in 28 patients, the present investigation was performed prospectively in 125 patients wearing 46 maxillary and 121 mandibular Bollard coping attached dentures, each supported by only two implants placed in the canine region. The Bollard attachments were processed as described in the previous study. Patients were recalled in yearly intervals for up to 12 years afterward, whereby findings of the peri-implant conditions, functional or total loss of implants, alterations of denture materials, as well as functional and esthetic parameters of the dentures were recorded. For comparison, findings of bar-and ball-retained implant-supported mandibular dentures with similar characteristics were recorded over a period of 5 years. The censored cause-specific time-to-event analysis (including competing risk regression) of data revealed a cumulative implant loss of 13.3% in the maxilla and 6.3% in the mandible when using Bollard attachments for 10 years. After 5 years, the loss of implants provided with Bollard copings amounted to 2.3% in the mandible and was significantly less than in bar-retained (8.7%, P = .002) or ball-retained prostheses (26.3%, P < .001). In addition, peri-implant findings of oral mucosa and bone as well as the plaque index were significantly more favorable when using Bollard copings for the attachment of dentures, yielding the type of attachment as a statistical variance factor. The quality of Molloplast B (DETAX) remained the same throughout the study period, and after 5 years of use only 5.9% of the lower secondary parts of the Bollard attachments had to be replaced in maxillary dentures and 14.7% in mandibular dentures. Conversely, ball attachments had to be rebuilt in 63% of dentures. Further repairs of the dentures were significantly less frequent in Bollard coping attached dentures than in any other type of prosthesis studied. Moreover, the subjective ratings of function and retention as well as of esthetic aspects like phonetics and oral comfort were better in dentures provided with Bollard copings than in those with bar or ball attachments

Solubility of dental core build-up materials in electric fields

Background/purpose: Over 250 years has been researched over the consequences of oral galvanism. Previous studies have already examined the influence on dental fixation materials. The aim of this study was to investigate the electro-chemical solubility behavior of different dental core build-up materials in a pseudo-realistic galvanic experimental setup. Materials and methods: The composite Admira (Voco, Cuxhaven, Germany) and two glass ionomer cements, Ketac Molar and Photac (3M-Espe, Seefeld, Germany), were examined. Test specimens were exposed to electric field strengths of 10-27 V/m in 0.9% saline solution. After 1, 2, 3, and 24 h, 2ml of the electrolyte was removed for analysis. Aluminum and calcium were selected as parameters to measure the solubility of the products. Differences between the test samples and controls were ascertained using the two sample t-test. Results: For all of the test groups, Admira demonstrated minimal solubility compared to Ketac and Photac. However, after 24 h in an electric field of 27 V/m, Admira demonstrated the highest increase in solubility compared to the controls (3.47 vs control at 0.76 mu mol/l). The second highest increase yielded the conventional glass ionomer cement Ketac (8.62 vs control at 5.28 mu mol/l), and a minor increase in solubility showed the composite-based glass ionomer material Photac (38.73 vs control at 31.78 mu mol/l) compared to the controls. Conclusion: This study demonstrated that galvanic processes increase the solubility of glass ionomer and composite. Therefore, the time of storage, electric field strength, and contact of the material with the electrodes significantly influenced their solubility. (C) 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V

Loss of A beta-nerve endings associated with the Merkel cell-neurite complex in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis

The Merkel cell-neurite complex initiates the perception of touch and mediates A beta slowly adapting type I responses. Lichen planus is a chronic inflammatory autoimmune disease with T-cell-mediated inflammation, whereas hyperkeratosis is characterized with or without epithelial dysplasia in the oral mucosa. To determine the effects of lichen planus and hyperkeratosis on the Merkel cell-neurite complex, healthy oral mucosa! epithelium and lesional oral mucosa! epithelium of lichen planus and hyperkeratosis patients were stained by immunohistochemistry (the avidin-biotin-peroxidase complex and double immunofluorescence methods) using pan cytokeratin, cytokeratin 20 (K20, a Merkel cell marker), and neurofilament 200 (NF200, a myelinated A beta- and A delta-nerve fibre marker) antibodies. NF200-immunoreactive (ir) nerve fibres in healthy tissues and in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis were counted and statistically analysed. In the healthy oral mucosa, K20-positive Merkel cells with and without close association to the intraepithelial NF200-ir nerve fibres were detected. In the lesional oral mucosa of lichen planus and hyperkeratosis patients, extremely rare NF200-ir nerve fibres were detected only in the lamina propria. Compared with healthy tissues, lichen planus and hyperkeratosis tissues had significantly decreased numbers of NF200-ir nerve fibres in the oral mucosal epithelium. Lichen planus and hyperkeratosis were associated with the absence of A beta-nerve endings in the oral mucosal epithelium. Thus, we conclude that mechanosensation mediated by the Merkel cell-neurite complex in the oral mucosa! epithelium is impaired in lichen planus and hyperkeratosis