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In a series of scanning electron microscopic studies, the reaction of osteogenic cells to hydroxylapatite (HA) implant materials was investigated in culture and following implantation. Tissue components as found in normal rat and dog bone were identified at the interface in both test systems. In vivo, implant bed cells showed an intimate contact with the HA surfaces. Osteoblasts deposited organic matrix and bone mineral in direct apposition to HA, with no evidence of encapsulation or granulation tissue. The development of such a direct spatial relationship appears to involve mechanisms more encompassing than epitaxis. [ABSTRACT FROM AUTHOR]

The article focuses on the development, animal experimentation and clinical trials of the ITI type H dental implants. The H implant have two external cylinders and a central hollow cylinder having a diameter of 3 mm. A perforated bar connects the cylinders. The shape allows broadly distributed force even under full load, while permitting bone growth through implant. Initially, the new precision instruments and the implant shape were tested with two mature beagles. Following satisfactory animal experiments, the implants were then clinically tested.

The article focuses on two patients whose displaced dental impression compounds were embedded into soft tissues or performed cavities. Radiographic examination is usually successful in detecting such materials, which may contain various particles. A woman underwent extraction of a tooth. However, large teeth root fragments were not removed during the procedure. Acute maxillary sinusitis, which developed after the extraction, was treated by an otolaryngologist. The patient suffered from facial swelling almost four years after the extraction was done. Dental impression material was found in the cheek tissue of a 75-year-old woman who underwent endodontic therapy.

A comprehensive classification of midfacial/craniofacial fractures, based on two- and three-dimensional computed tomography (2D and 3D-CT) is presented. We performed a postmortem analysis of 24 patients who had died from trauma with signs of craniofacial fractures, based on 2D and 3D-CT studies with pathoanatomical findings. In addition, CT findings for 100 patients with craniofacial injuries requiring an emergency CT were correlated with surgical findings and follow-up results. On the basis of the analysis of a total of 377 fractures a classification system is proposed. The system is based on the use of the AO/ASIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation) scheme, defining three types (A, B, C), three groups within each type (e.g. A1, A2, A3) and three subgroups within each group (e.g. A1.1, A1.2, A1.3) with increasing severity from A1.1 (lowest) to C3.3 (highest). The craniofacial region is divided into three units: the lower midface (I), the upper midface (II) and the craniobasal-facial unit (III). Lateral and central fractures are also distinguished. Type A fractures are non-displaced fractures, type B are displaced fractures and type C are complex/defect fractures. Groups A1, B1 and C1 comprise fractures of an isolated unit; groups A2, B2 and C2, combined fractures without involvement of the skull base; and groups A3, B3 and C3 are those combined fractures with involvement of the skull base. A correlation between the severity of the fracture and (i). the number of posttraumatic functional limitations (Spearman rank test, correlation coefficient r=0.42), (ii). the need for bone grafting or dural plastic (r=0.39) and (iii). facial asymmetry (r=0.37), was observed. The proposed classification system allows standardised documentation of midfacial and craniofacial fractures, including those not precisely defined by the Le Fort classification scheme.

Background: Plateosteosynthesis by intraoral approach of mandibular fractures gives the best cosmetical result but presents a rather difficult procedure., Aims: Comparison of intra- versus extraoral approach in plateosteosynthesis of mandibular fractures., Methods: Plate type, experience of the surgeon, age and sex of the patient, as well as hospital stay and rate of the septic complications were analysed retrospectively in 248 patients of the OMF Department (University Freiburg) with mandibular fractures with respect in view of the operative approach used., Results: The method of osteosynthesis was found to be the strongest determinant. Concerning the surgical approach significant correlation was found between age and sex, and surgical experience. Operative approach was found to have no effect on hospitalization and septic complications., Conclusion: Operative approach does not have either medical nor economical consequences in the surgical management of mandibula fractures.