Oral health and oral health-related quality of life in patients with oral dystonia indicates their need for dental special care

This retrospective study aimed in the evaluation of oral health and oral health-related quality of life (OHRQoL) of patients with oral dystonia (OD). Seventeen patients with OD (Meige Syndrome: n=11, Oromandibular Dystonia: n=6) were included, of which seven were examined again at three months after botulinum toxin injection. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14). Within oral examination, dental parameters, remaining teeth and periodontitis severity were assessed. A matched healthy control (HC) was composed for comparison. The OD patients had significantly more carious teeth (0.94 ± 1.75 vs. 0; p<0.01), less remaining teeth (15.65 ± 9.89 vs. 22.22 ± 5.91; p=0.01) and higher dental treatment need than the HC (42.9% vs. 0%; p<0.01). The OHIP G14 sum score of 9.47± 9.82 vs. 1.58 ± 2.79 (p<0.01) as well its dimensions psychosocial impact (4.47 ± 6.45 vs. 0.53 ± 1.16; p=0.03) and oral function (4.35 ± 2.98 vs. 0.47 ± 1.34; p<0.01) were clinically relevant and statistically significant higher in OD compared to HC group. No significant differences could be detected at three months after botulinum toxin injection. Patients with OD suffer from more dental diseases and have a worse OHRQoL than HC. Dental special care appears recommendable and should be fostered by everyone, who is involved in the treatment of patients with OD

Oral health-related quality of life of patients after solid organ transplantation is not affected by oral conditions:results of a multicentre cross-sectional study

This multicentre cross-sectional study aimed in examination of oral health-related quality of life (OHRQoL) of patients after solid organ transplantation (SOT). Patients after SOT (liver, lung and heart) at one out of three German centers (Goettingen, Essen, Leipzig) were included. For comparison, a healthy control (HC) was recruited. OHRQoL was assessed by German short form of oral health impact profile (OHIP G14). Oral examination comprised: decayed-, missing- and filled-teeth index (DMF-T), remaining teeth and periodontitis severity. In total, 196 patients after SOT and 130 HC with comparable age, gender and smoking habits were included (p>0.05). DMF-T and number of remaining teeth was worse in SOT group (p0.05). Number of remaining teeth was not an independent predictor of OHIP G14 sum score in SOT (? -0.082, CI95 -0.156 - 0.045, p=0.28). OHRQoL of SOT recipients is not affected by their oral condition, leading to the assumption that the individual perception of patients physical oral health is not in line with the clinical situation

Association of time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected bacteria of patients after solid organ transplantation

Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT). 169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Periodontal probing depth (PPD) and clinical attachment loss (CAL) were assessed. Periodontal disease severity was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were investigated for eleven selected potentially periodontal pathogenic bacteria using polymerasechainreaction. The mean PPD and CAL as well as prevalence of Treponema denticola and Capnocytophaga species was shown to be different but heterogeneous depending on time under immunosuppression (p<0.05). Furthermore, only the medication with Cyclosporine was found to show worse periodontal condition compared to patients without Cyclosporine (p<0.05). Prevalence of Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum was reduced and prevalence of Parvimonas micra and Capnocytophaga species was increased in patients under immunosuppression with Glucocorticoids, Mycophenolate as well as combination therapy. Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT. Patients under Cyclosporine medication should receive increased attention. Differences in subgingival biofilm, but not in clinical parameters were found for Glucocorticoids, Mycophenolate and combination therapy, making the clinical relevance of this finding unclear

Effectiveness and safety of opicapone in Parkinson’s disease patients with motor fluctuations: the OPTIPARK open-label study

Background The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. Methods OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Results Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. Conclusions Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. Trial registration Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Dialysis vintage time has the strongest correlation to psychosocial pattern of oral health-related quality of life - a multicentre cross-sectional study

Schwerpunkt der publikationsbasierten Promotion war die Mundgesundheitsbezogene Lebensqualität (MLQ) von Hämodialysepatienten (HD) und der Einfluss der Dialysedauer sowie des dentalen und parodontalen Behandlungsbedarfes auf diesen subjektiven Parameter. Dabei sollte anhand der vier Dimensionen der MLQ mit Schwerpunkt auf 'orale Funktion' und 'psychosozialer Einfluss' herausgefunden werden, ob orale Funktion, psychosoizales Leid oder eine Kombination aus beidem mehr Relevanz in dieser heterogenen Patientengruppe hat. Die HD-Patienten wurden in 6-Dialysedauergruppen (0-2 Jahre, 3-5 Jahre, 6-8 Jahre, 9-12 Jahre, 13-20 Jahre und >20 Jahre) unterteilt, die auf gleichen Perzenten beruhten und eine Minimumgröße von 25 Patienten aufweisen sollten. Ein dentaler Behandlungsbedarf bestand bei einem D-T Wert von 1, ein parodontaler Behandlungsbedarf bei einer Sondierungstiefe von >3,5mm (orientiert am PSI). Zusammenfassend konnte festgestellt werden, dass sich die MLQ wiedererwartend mit steigender Dialysedauer verbessert. Dieser Umstand geht womöglich mit einer geringeren Beeinträchtigung im psychosozialen Bereich einher, da gerade zu Beginn der Therapie die Dimension 'psychosozialer Einfluss' eine große Bedeutung hat. Weiterhin war der gesamte zahnärztliche Behandlungsbedarf in der Kohorte sehr hoch. Jedoch konnte kein Zusammenhang mit der MLQ gefunden werden. Den HD-Patienten scheint ihr Defizit nicht bewusst zu sein. Als Fazit sollte die Mundgesundheit von HD-Patienten dringend verbessert werden sowie das Bewusstsein für mundgesunde Verhältnisse. Systematische Komplikationen können dadurch reduziert werden. Zudem sollte eine verstärkte psychosoziale Betreuung zu Beginn der Therapie erfolgen um den Einschnitt in die Lebensqualität so gering wie möglich zu halten.:Abkürzungsverzeichnis 1. Einleitung 1.1 Hämodialyse 1.2 Die Mundgesundheit Erkrankungen der Mundhöhle 1.2.1 Karies 1.2.2 Parodontitis 1.3 Mundgesundheitszustand von HD-Patienten 1.4 Mundgesundheitsbezogene Lebensqualität von HD-Patienten 1.5 Zielsetzung und Fragestellung 2. Publikationsmanuskript 3. Zusammenfassung der Arbeit 4. Ausblick 5. Literatur 6. Wissenschaftliche Präsentationen 7. Darstellung des eigenen Beitrages 8. Erklärung über die eigenständige Abfassung der Arbeit 9. Lebenslauf 10. Danksagun