Impact of foods with health logo on ssaturated fat, sodium and sugar intake of young Dutch adults

Objective Health logos are introduced to distinguish foods with ‘healthier’ nutrient composition from regular foods. In the present study, we evaluated the effects of changed food compositions according to health logo criteria on the intake of saturated fat, sugar and sodium in a Dutch population of young adults. Design Foods in the Dutch food composition table were evaluated against nutrient criteria for logo eligibility. Three replacement scenarios were compared with the nutrient intake ‘as measured’ in the Dutch consumption survey. The foods not complying with health logo criteria were replaced either by ‘virtual’ foods exactly complying with the health logo criteria, with real 2007 market shares (scenario I) and 100 % market shares (scenario II), or by existing similar foods with a composition that already complied with the health logo criteria (scenario III). Results The percentage reduction in nutrient intake with the current 2007 market shares of ‘health logo foods’ was -2·5 % for SFA, 0 % for sodium and -1 % for sugar. With a 100 % market share these reductions would be -10 % for SFA, -4 % for sodium and -6 % for sugar. This may lead to a reduction of -40 % for SFA, -23 % for sodium and -36 % for sugar in the most optimal replacement scenario. Conclusions With ‘health logo foods’, available in 2007 and current consumption patterns, small reductions can be achieved for SFA and sugar. For additional reductions, lowering the fat/sodium content of meat (products) towards health logo criteria and drinks without sugar towards limits far below health logo criteria would be the most effective reformulation strategy

Secondary surgical management of osteoradionecrosis using three-dimensional isodose curve visualization:a report of three cases

Osteoradionecrosis is defined as bone death secondary to radiotherapy. There is a relationship between the radiation dose received and the occurrence of osteoradionecrosis of the jaws, with the risk increasing above a dose of 60Gy. In cases of class III mandibular osteoradionecrosis, a segmental resection can be indicated. Current practice is to completely remove the affected bone up to the point where the bone looks healthy and is bleeding. Exact resection planning and the use of guided surgery based on imaging of the bone changes have not been reported so far. This article describes a method whereby the radiotherapy dose information is incorporated into the imaging of the affected bone in order to plan a three-dimensional (3D) virtual guided resection and reconstruction of the mandible in osteoradionecrosis. The method enables 3D visualization of each desired dose field in relation to the 3D model of the affected bone. Two types of application - for resection and reconstruction - are described.</p

Full 3-D digital planning of implant-supported bridges in secondary mandibular reconstruction with prefabricated fibula free flaps

Objectives In the reconstruction of maxillary or mandibular continuity defects in dentate patients, the most favourable treatment is placement of implant-retained crowns or bridges in a bone graft that reconstructs the defect. Proper implant positioning is often impaired by suboptimal placement of the bone graft. This case describes a new technique of a full digitally planned, immediate restoration, two-step surgical approach for reconstruction of a mandibular defect using a free vascularised fibula graft with implants and a bridge. Procedure A 68-year-old male developed osteoradionecrosis of the mandible. The resection, cutting and implant placement in the fibula were virtually planned. Cutting and drilling guides were 3-D printed, and the bridge was computer aided design-computer aided manufacturing (CAD-CAM) milled. During the first surgery, two implants were placed in the fibula according to the digital planning, and the position of the implants was scanned using an intra-oral optical scanner. During the second surgery, a bridge was placed on the implants, and the fibula was harvested and fixed in the mandibular defect, guided by the occlusion of the bridge. Conclusion Three-dimensional planning allowed for positioning of a fibula bone graft by means of an implant-supported bridge, which resulted in a functional position of the graft and bridge.</p

Full 3-D digital planning of implant-supported bridges in secondary mandibular reconstruction with prefabricated fibula free flaps

Objectives In the reconstruction of maxillary or mandibular continuity defects in dentate patients, the most favourable treatment is placement of implant-retained crowns or bridges in a bone graft that reconstructs the defect. Proper implant positioning is often impaired by suboptimal placement of the bone graft. This case describes a new technique of a full digitally planned, immediate restoration, two-step surgical approach for reconstruction of a mandibular defect using a free vascularised fibula graft with implants and a bridge. Procedure A 68-year-old male developed osteoradionecrosis of the mandible. The resection, cutting and implant placement in the fibula were virtually planned. Cutting and drilling guides were 3-D printed, and the bridge was computer aided design-computer aided manufacturing (CAD-CAM) milled. During the first surgery, two implants were placed in the fibula according to the digital planning, and the position of the implants was scanned using an intra-oral optical scanner. During the second surgery, a bridge was placed on the implants, and the fibula was harvested and fixed in the mandibular defect, guided by the occlusion of the bridge. Conclusion Three-dimensional planning allowed for positioning of a fibula bone graft by means of an implant-supported bridge, which resulted in a functional position of the graft and bridge.</p