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Introduction: MPFL reconstruction represents one of the most important surgical treatment options for recurrent patellar dislocations at low flexion angles associated with low flexion patellofemoral instability. Nevertheless, the role of quadriceps muscles in patients with patellofemoral instability before and after patellofemoral stabilization using MPFL reconstruction has not been fully elucidated. The present study investigates the influence of quadriceps muscles on the patellofemoral contact in patients with low flexion patellofemoral instability (PFI) before and after surgical patellofemoral stabilization using MPFL reconstruction using 3 T MRI datasets in early degrees of flexion (0-30°)., Methods: In this prospective cohort study, 15 patients with low flexion PFI before and after MPFL reconstruction and 15 subjects with healthy knee joints were studied using dynamic MRI scans. MRI scans were performed in a custom-made pneumatic knee loading device to determine the patellofemoral cartilage contact area (CCA) with and without quadriceps activation (50 N). Comparative measurements were performed using 3D cartilage and bone meshes in 0-30° knee flexion in the patients with patellofemoral instability preoperatively and postoperatively., Results: The preoperative patellofemoral CCA of patients with low flexion PFI was 67.3 ± 47.3 mm 2 in 0° flexion, 118.9 ± 56.6 mm 2 in 15° flexion, and 267.6 ± 96.1 mm 2 in 30° flexion. With activated quadriceps muscles (50 N), the contact area was 72.4 ± 45.9 mm 2 in extension, 112.5 ± 54.9 mm 2 in 15° flexion, and 286.1 ± 92.7 mm 2 in 30° flexion without statistical significance. Postoperatively determined CCA revealed 159.3 ± 51.4 mm 2 , 189.6 ± 62.2 mm 2 and 347.3 ± 52.1 mm 2 in 0°, 15° and 30° flexion. Quadriceps activation with 50 N showed a contact area in extension of 141.0 ± 63.8 mm 2 , 206.6 ± 67.7 mm 2 in 15° flexion, and 353.5 ± 64.6 mm 2 in 30° flexion, also without statistical difference compared with unloaded CCAs. Subjects with healthy knee joints showed an increase of 10.3% in CCA at 30° of flexion (p = 0.003)., Conclusion: Although patellofemoral CCA increases significantly after isolated MPFL reconstruction in patients with low flexion patellofemoral instability, there is no significant influence of quadriceps muscles either preoperatively or postoperatively., (© 2023. The Author(s).)

Background: The pathophysiological mechanisms of macular edema secondary to branch retinal vein occlusion (BRVO) remain unclear., Objectives: To analyze the protein profile of human vitreous of patients with BRVO and to identify specific dysregulated proteins., Materials and Methods: Undiluted vitreous humor samples from patients with treatment naïve BRVO and 15 controls with idiopathic floaters were analyzed in this clinical-experimental study using capillary electrophoresis coupled to a mass spectrometer (CE-MS) and tandem mass spectrometry (MS/MS). Quantitative analysis of the dysregulated proteins was performed with enzyme-linked immunosorbent assay (ELISA). Protein-protein interactions were depicted with the STRING database., Results: A total of 84 proteins were found in the human vitreous samples of 15 patients with BRVO and 15 controls. In all, 14 proteins were significant when comparing the signal intensities of BRVO and control samples. Six significant dysregulated proteins with p < 0.001 were further verified with ELISA. Clusterin, complement factor C3, prostaglandin-H2 D‑isomerase and vitronectin were significantly upregulated in the BRVO group and opticin was downregulated. The protein interactions analysis showed associations with inflammatory cascades, matrix changes, mechanisms of cell survival und death., Conclusions: The results of the study reveal that the proteomic composition of vitreous humor differed significantly between the patients with BRVO and the controls. Whether the identified proteins may serve as potential biomarkers for pathophysiology, diagnostics or therapy should be examine in further studies.

The updated German clinical practice guidelines (second edition) describe the consensus recommendations for prevention and treatment of retinal complications secondary to diabetes. According to the updated numbers on epidemiology a further increase of persons affected is expected. The prevalence of diabetic retinopathy is estimated to be 9-16 % in type 2 diabetes and 24-27 % in type 1 diabetes. A prolongation of the screening interval from 1 to 2 years is recommended for those patients with a lower risk of progression, when retinopathy has not already occurred and no increased systemic risk factors are present. Standardized documentation forms are the foundation for improved communication between the disciplines. If diabetic retinopathy is present, control examinations follow the stipulations of the ophthalmologist. The guidelines define scenarios when the use of optical coherence tomography (OCT) is necessary, e. g. diagnosis and follow-up of macular edema. Besides focal and panretinal laser therapy, the efficacy and risks of intravitreal operative pharmacotherapy are discussed. Focal laser coagulation is recommended for therapy of macular edema without foveal involvement and for macular edema with foveal involvement patients should be informed about the effective alternative forms of treatment. Panretinal laser coagulation is recommended for first line treatment of proliferative diabetic retinopathy and is optional for severe non-proliferative retinopathy.

The present clinical study evaluates the clinical prognosis of Cerec3D endocrowns over an observation period of two years. Twenty Cerec endocrowns (VITABLOCS Mark II, Vita Zahnfabirk, Bad Säckingen, Germany) were placed with PanaviaTM F 2.0, a dual-curing bonding composite. The control examinations took place semi-annually and the restorations were evaluated based on modified US Public Health Service criteria (USPHS). The two-year survival rate of the Cerec endocrowns was 90%. Two out of 20 endocrowns were assessed as failure because of fractures. The first fracture was observed after 12 months and the second fracture after 18 months. No recurrent caries was diagnosed during the entire examination period. Slight percussion symptoms were found on three restorations in the first weeks after placement. The results of the present study show that good esthetic and functional results similar to those of other restoration types can be achieved with endocrowns and that CAD/CAM-fabricated crowns represent a very promising treatment alternative for endodontically treated molars.

The objective of the present study was to determine the clinical success of Cerec 3D inlays over a period of three years. Within the scope of the restorative dentistry course II, 62 Cerec ceramic inlays were inserted with Dual Cement (Ivoclar Vivadent) in combination with the Syntac Classic system (Ivoclar Vivadent). Regular follow-up examinations and assessments were performed by reference to modified US Public Health Service (USPHS) criteria. The baseline examination was performed one week after insertion and further follow-up examinations were performed at 6-month intervals. The survival rate of the Cerec 3D inlays was 95% after three years. Three inlays were assessed as failures because of loss of sensitivity, restoration fracture, and marginal gap formation. Six patients initially suffered from postoperative hypersensitivity, which vanished by the first follow-up examination. The results of this study show that dentists with little experience are able to achieve good clinical results and long-term success after short theoretical as well as practical training and an introductory course in the Cerec method.