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The successful application of the concept of computer-assisted manufacturing in restorative dentistry requires that computer-assisted design (CAD) and computer-assisted machining (CAM) not only meet but actually exceed currently accepted standards for the material and clinical quality of dental restorations. In addition, the continued development of systems for polyvalent processing of disparate materials and objects must be assured. With these critical requirements in mind, the Precident system is a clinically proven and competitive system. The resolving power of the CCD chip is much improved compared to conventional cameras or charge-coupled devices. The scanner is able to scan entire casts in a fully automated process. In principle, this facilitates the production of frameworks for fixed prosthetic devices (FPD) of any size. It is also possible to create at least partial frameworks for removable prosthetic devices (RPD). A factor of great clinical and economic importance is the polyvalence of the process in materials processing: the numeric control (NC) machine can be programmed for metal alloys and ceramic materials as well as fiber-reinforced resins. At Aeskulap Klinik, the Precident System is routinely used for producing all single crowns and FPDs with up to four units. CAD/CAM all-ceramic crowns and FPDs currently cost about the same as metallo-ceramic or conventional all-ceramic restorations.

A 29-year-old patient with AIDS was hospitalized with weight loss, fever and cough. Mycobacterial cultures from sputum, blood and bronchoalveolar lavage became positive after 3 weeks' incubation. When using a DNA probe for identification of Mycobacterium tuberculosis complex, a weakly positive signal was obtained. Tuberculosis was suspected and treatment was started with isoniazid, ethambutol and ciprofloxacin. Sequencing of the gene of the 16S rRNA, however, identified the isolates as belonging to a new, slow-growing atypical mycobacterial species, Mycobacterium celatum (M. celatum). Treatment was modified to take into account the previously described primary resistance of M. celatum to antituberculous drugs, whereupon the patient improved.

We present a new method of fixation for creation of the vestibular sulcus in cases of open or closed submucous vestibuloplasty. Kirschner-wires (diameter 0.5 mm) are drilled through the mucous membrane into the bone. The wires keep the hand cut oval elastic sheets in place to adapt the mucous membrane to the periosteum at the deepest point of the vestibule respectively. Advantages of the method in comparison to other fixation techniques are discussed.

Presentation of a case of a congenital analgia, who showed as a complication a chronical osteomyelitis of the mandible with formation of sequester and fracture. Partial resection of the mandible and immediate reconstruction was done performing simultaneously a rebuilding of the atrophied alveolus by the use of split ribs and fixation with a long miniplate.

We report on two patients with actinomycosis. The first case was a 45-year-old cachectic man with extensive bilateral pulmonary infiltrates. The lesions remained unclear for 18 months and only open lung biopsy with microscopic and cultural evaluation led to the diagnosis of actinomycosis. In the second case, classic cervico-facial actinomycosis in a 69-year-old farmer is described. Diagnosis was established on the basis of microscopic findings of "sulphur granules" eroding the mandible. Furthermore, the clinical presentation, with an indurated swelling of the jaw and intraoral fistula formation, was typical. The patient had a severe combined aortic valve lesion and died after ventricular fibrillation during hospitalization. Diagnosis could not be confirmed by culture, probably due to antibiotic prophylaxis against endocarditis during tooth extraction on the first day of admission. Diagnostic difficulties and microbiologic aspects are discussed, with special focus on the rare species of Actinomyces meyeri which was cultured from biopsy specimens from the lung of the first patient. So far this species has been described in only 13 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

We present our experiences after the filling of cysts and cystoid processes with lyophilized cartilage. The largest diameter of the cyst measured on the x-ray was never smaller than 15 mm. We controlled the calcification and ossification on the x-ray after a period of 6 to 12 months in 14 cases. In all of our cases we noticed a primary wound healing after the implantation of the cartilage under a prophylactic antibiotic treatment. Our good results justify to use chips of lyophilized cartilage as a filling material of large bone defects.