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Objectives Cryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long‐term prognosis of the teeth. Material and methods Twenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at −80°C (group 1) and −196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load. Results No significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests. Conclusions Conclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.

AIMS The aim of this prospective, clinical study was to evaluate the clinical performance and histological outcome of a new equine hydroxyapatite collagenated bone block (eHAC) for horizontal bone grafting prior to implant placement. MATERIALS AND METHODS Five patients (two male/three female) with a mean age of 51.6 years (range 22-66 years) and a reduced horizontal bone width of the alveolar ridge (mean 3.5 mm) underwent horizontal bone grafting using eHAC at 10 grafting sites. Reentry was performed 6.9 months after the horizontal grafting procedure. Clinical follow-up (mean 28.9 month) considered width gain of the alveolar ridge, soft tissue healing, and complications. To evaluate graft incorporation, four additional patients underwent histological assessment of equine blocks adjacent to autologous blocks 3 and 6 months after grafting. RESULTS The study was terminated after graft failure was observed in four of five patients. Mean horizontal bone width had increased by 3.6 ± 1.22 mm. Three out of nine implants placed had to be removed due to graft failure. Histological evaluation revealed large amounts of soft connective tissue within the grafts (mean 67.3 ± 9.5%). The proportion of new bone formation 3 months after the lateral grafting procedure revealed an average of 8.6%, compared to 11.4% after 6 to 7 months. CONCLUSION Lateral ridge grafting using eHAC achieved measurable horizontal width gain but revealed high rates of severe complications. CLINICAL IMPLICATIONS Within the limitations of this study, eHAC bone blocks cannot be recommended for horizontal bone grafting.

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As a possible reason for mechanical and microbiological complications, the stability of conical implant-abutment and butt-joint connections is crucial for the long-term prognosis of dental implants.Therefore, the present study quantitatively assessed microgap formation and abutment displacement in different implant-abutment designs. Three implant systems with conical implant-abutment connections Medentika, Medentis, NobelActive and one system with a butt-joint connection Semados implants were tested. For different static loadings and angles (30 N - 90º, 100 N - 90º, 200 N - 30º) abutment displacement and microgap formation were calculated using synchrotron-based microtomography and phase-contrast radioscopy. The method using numerical forward simulation of the optical Fresnel propagation allowed for an accuracy down to 0.1 µm. Microgaps were present in all implant systems prior to loading (0.15 - 9µm). Values increased with mounting force and angle up to 40.5 µm at an off axis loading of 100 N in a 90 degree angle. In contrast to butt-joint connections conical connections demonstrated a tilting abutment displacement with a deformation of the outer implant wall visible in Medentika implants. The connection design seems to be crucial for the force distribution on the implant wall. Varying force distribution could lead to peri-implant bone loss under favorable conditions such as peri-implant inflammation.

Premolar autotransplantation represents an effective therapeutic option for the treatment of juvenile dentition with either aquired or congenital hypodontia. The objective of this prospective clinical study was to quantitatively assess bone and soft tissue levels after autogenous premolar transplantation by clinical and radiographic parameters.In the study, 26 premolars were transplanted in 20 patients after traumatic tooth loss (n = 16) or congenital aplasia (n = 10) in the anterior maxilla. Based on standardized photographic documentation, the relative soft tissue level was measured compared to the healthy adjacent teeth. Radiographic findings included evaluation of root resorption, pulp canal obliteration, and relative bone height.Average survival rate of transplanted premolars (n = 26) was 100% over a follow-up period of 29 months (range 10-60 months). The relative soft tissue level significantly increased by +1.1 mm (P .01). Radiographs showed a tendency toward vertical bone growth. Continuous root development and signs of pulpal healing were observed postoperatively in 18 transplants (69.2%).Autogenous premolar transplantation represents a safe method to ensure functional and aesthetic rehabilitation in the anterior maxilla irrespective of the nature of tooth loss.

Background: To present a new idea for rapid management of tooth avulsion in young children and adolescents (age: 6 to 16) by this case report. Case presentation: A nine-year-old boy presented with loss of upper permanent central incisor in early mixed dentition (6 to 10 years, phase I). The not yet fully resorbed primary canine was used as tooth transplant for the lost incisor. The intentional renounce on endodontic treatment of the primary transplant permits natural exfoliation of the transplant occurring either spontaneously or due to undermining resorption through the adjacent erupting teeth. In the late mixed dentition (10 to 16 years, phase II), the primary tooth transplant is electively removed and replaced by a premolar autotransplant for long-term rehabilitation of the meanwhile adolescent patient. Results: Primary canine autoTX acts as a temporary denture with instant surgical gap closure. Ensuing premolar autoTX in phase II then acts as permanent denture with excellent 10 years survival rates. Patient satisfaction issued by a questionnaire resulted in good to very good school grades for both phases of autotransplantation. Conclusions: The “TPTX” concept is a new surgical approach that immediately restores the patient’s function and aesthetics after tooth loss in early childhood supporting the growth of local bone and soft tissue in the growing adolescent jaw.

This case report demonstrates the ablation of a dermal nevus using a diode laser in the esthetically very demanding facial area of the nasal tip. The clinical outcome shows good results and a high level of patient satisfaction. Due to effective wound granulation and healing, elaborate skin grafts could be avoided. The application of the contact laser ensures safe treatment in highly perfused areas thanks to haptic feedback and good coagulative effect. The method should therefore be considered as an alternative to other ablative procedures for benign lesions in the facial area.

Introduction: Fibrous dysplasia appears in a clinically and radiologically variable way. Radiographic diagnostic is an important factor for final diagnosis especially as this rare lesion is often observed accidently in dental radiographic examinations. Therefore, the present case report demonstrates deviating clinical and radiological manifestations of monostotic and polyostotic forms of fibrous dysplasia (FD) in the facial area and its impact on dental and surgical therapy. Presentation of case: In the first patient, showing a monostotic form a hard, non-compressive swelling in the lower incisor area was detectable and radiographic investigation showed a “ground glass”-like radiopacity in the lower mandible. A surgical reduction of the process and a biopsy were indicated due to progression of the lesion and the development of aesthetic impairment at a young age. In the second patient, with a polyostotic manifestation, radiographic investigation revealed mixed heterogeneous sclerotic areas in the left mandibular angle and a “ground glass”-like pattern and osteolyses spreading out from the sphenoid sinus. A biopsy was obtained to confirm the radiological diagnosis without complete removal of the diseased bone. Conclusion: The two cases demonstrate the strongly varying clinical and radiological appearances of craniofacial FD and underline why it poses a challenge to the medical and dental practitioner. Furthermore, the present case report is discussing different diagnostic and therapy concepts according to different forms of FD and the consequences for dental therapy. Therapy strategies should always be determined by the progression and dimension of the disease and requires close interdisciplinary cooperation.

Introduction Intraaortic balloon pump counterpulsation (IABP) is often used in patients with acute coronary syndrome for its favourable effects on left ventricular (LV) systolic function and coronary perfusion. However, the effects of IABP on LV diastolic function have not been comprehensively investigated. Acute diastolic dysfunction has been linked to increased morbidity and mortality. The aim of this study was to examine the influence of IABP on LV diastolic dysfunction using standard TEE derived parameters. Methods Intraoperative TEE was performed in 10 patients (mean age 65 ± 11 yrs) undergoing urgent coronary artery bypass graft surgery (CABG), who had received an IABP preoperatively. TEE derived measures of diastolic dysfunction included early to late transmitral Doppler inflow velocity ratio (E/A), deceleration time (Dt), pulmonary venous systolic to diastolic Doppler velocity ratio (S/D), transmitral propagation velocity (Vp), and the ratio of early to late mitral annular tissue Doppler velocities (e’/a’). Statistical analyses included the Wilcoxon Sign-Rank test, and a p

Objective. The aim of this study was to investigate whether the growth of soft tissue and bone in children with traumatic tooth loss or agenesis of teeth can be developed reliably, using a new technique of autogenous primary canine transplant. Study Design. A total of 10 patients (age range, 7-13 years) were treated either for trauma or for agenesis (n ¼ 14 primary canine transplants). In addition to the clinical examination, patients were subjected to radiologic examinations with regard to root resorption, bone height, and soft tissue level. Results. With an average survival rate of 87%, the average survival time of the transplants using the Kaplan-Meier estimator was 5.2 years. In all cases, soft tissue and bone growth was effectively developed. Conclusions. Autogenous primary canine transplant is a reliable surgical method for rehabilitating children in the early mixed dentition after traumatic tooth loss, enabling adequate soft tissue and bone growth. (Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:158-169) The lack of a permanent upper incisor, either due to traumatic loss in the early mixed dentition (ages 6 to 10 years) or due to congenital tooth agenesis, always presents the dentist with the difficult task of satisfactorily rehabilitating the affected patients in terms of both aesthetics and function. Epidemiologic studies have found that in Europe, every second child experiences a tooth trauma before the age of 16 years 1,2 ;8 % to 10% of all dental injuries are injuries with loss of permanent teeth. 3 In contrast to traumatic tooth loss, multiple aplasia of teeth is rather rare in the maxillary anterior region. Nevertheless, it presents the dentist with a difficult task, as natural bite raising with alveolar process growth does not occur, owing to the absence of tooth development. The incidence of aplasia in adolescent dentition is found to be approximately 8%. 4 The loss of a permanent tooth in adolescent dentition, and also agenesis of the corresponding tooth, is always accompanied by an inhibition of the vertical and horizontal alveolar process growth. 5 Especially between the ages of 6 and 10 (in the so-called early mixed dentition), a fixed restoration of existing primary or traumatically incurred tooth gaps is not possible because during this time, neither orthodontic gap closure nor endosseous implantation are available as treatment options. Endosseous implants placed before the completion

Objective To study differences between aspirin-tolerant patients and aspirin-intolerant patients concerning vascular endothelial growth factor (VEGF) expression. Recent publications strongly suggest the involvement of VEGF and its receptors in the pathophysiologic process of nasal polyps. Design We subjected 43 polyp specimens to semiquantitative immunohistochemical analysis. We quantified VEGF and its receptors (Flk, Flt, and neuropilin) in all samples. To gain insight into potential VEGF-mediated cellular responses, we determined proliferative (Ki67) and apoptotic (caspase 3) indices. Patients Polyp samples were obtained from 22 aspirin-intolerant patients and from 21 aspirin-tolerant patients, and control specimens were obtained from 24 subjects with healthy nasal respiratory mucosa. Setting Laboratory; Department of Otorhinolaryngology–Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. Main Outcome Measures Expression levels of VEGF, VEGF receptors. and proliferative and apoptotic indices. Results We found higher expressed levels of VEGF and neuropilin and stronger proliferation in nasal polyps from aspirin-tolerant and aspirin-intolerant patients compared with controls. In polyps from aspirin-intolerant patients, VEGF was expressed at considerably higher levels compared with those from aspirin-tolerant subjects. Apoptotic activity remained unchanged in all 3 groups. Conclusions Nasal polyps from aspirin-tolerant and aspirin-intolerant patients are characterized by strong proliferation and high levels of VEGF and neuropilin expression. Nasal polyps from aspirin-intolerant patients show distinctly increased VEGF levels. The relevance of these findings for future therapeutic approaches is yet to be determined.