Poliklinik für Zahnärztliche Prothetik

Popular media now often present 3D printing as a widely employed technology for the production of dental prostheses. This article aims to show, based on factual information, to what extent 3D printing can be used in dental laboratories and dental practices at present. It attempts to present a rational evaluation of todays´ applications of 3D printing technology in the context of dental restorations. In addition, the article discusses future perspectives and examines the ongoing viability of traditional dental laboratory services and manufacturing processes. It also shows which expertise is needed for the digital additive manufacturing of dental restorations.

AIMS: To investigate the course of myofascial pain defined by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) over a period of 5 years, and to identify prognostic factors from baseline data. METHODS: Subjects were 155 consecutive patients and 80 community cases identified from an age-stratified representative population sample; all met the primary selection criterion of reporting pain in the temporomandibular joint (TMJ) or masticatory muscles. The 2 groups were combined to yield a total sample of 235 subjects (50 male, 185 female; mean age = 39 years). Subjects were evaluated at baseline, 1 year, 3 years, and 5 years by trained examiners using standardized, reliable methods. Psychological and behavioral factors were assessed by self report. RESULTS: According to RDC/TMD criteria, 50 (31%) of the 165 subjects presenting with myofascial pain (MFP) at baseline continued to have their disorder over a period of 5 years; 55 (33%) remitted, and 60 (36%) were recurrent cases. Bivariate statistics and multivariate logistic regression analyses indicated that baseline pain frequency, number of painful palpation sites, and total number of body sites with pain were significant predictors of persistent vs remitted and recurrent cases. No predictors that distinguished remission vs recurrence could be identified. Thirty subjects from the 70 without a diagnosis of MFP at baseline developed a new MFP. A high baseline somatization score (without pain items) was a significant risk factor for onset of MFP. CONCLUSION: Muscle disorders classified by RDC/TMD are predominantly chronic or fluctuating pain conditions, with a modest probability (31%) of remission.

Previous studies on the prevalence of signs of temporomandibular disorders (TMD) in elderly people have used non-standardized and invalidated examination protocols. The prevalence of the different signs of TMD in this group is therefore still unclear. The aim of this study was to evaluate the prevalence of signs of TMD in subjects of advanced aged, using a standardized and validated examination protocol. Additionally, young subjects were examined as a control group. Fifty-eight old peoples' home inhabitants and 44 young subjects were examined using a standardized and validated examination protocol. Differences between the groups were assessed using Mann-Whitney U-test or t-test. Geriatric subjects more often exhibited objective symptoms of TMD (38% exhibited joint sounds on opening), but rarely suffered from pain (pain at rest: 0%, joint pain: 0%, muscle pain: 12%). In contrast, young subjects rarely exhibited objective symptoms (joint sounds: 7%), but suffered more frequently from pain (facial: 7%, joint pain: 16%, muscle pain: 25%). The mandibular range of motion was higher in young subjects. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (joint sounds) of TMD, they rarely suffered from pain. In contrast, younger subjects rarely exhibited objective TMD signs but more frequently suffered from subjective signs (muscular pain on palpation) and facial pain.

This article reviews allergen-specific immunotherapy in human and veterinary medicine. Current hypotheses of possible mechanisms of actions are outlined. Indications, success rates, adverse effects and factors influencing outcome of therapy are discussed in humans, dogs, cats and horses.

OBJECTIVES: Translation, reliability analysis and validation of a German version of the Geriatric/General Oral Health Assessment Index (GOHAI) was the aim of this study. METHODS: Translation was performed by a forward-backward process. Validity was assessed as convergent validity in comparison with another self-perceived assessment of oral health (OHIP-14) and as group validity (n = 218; mean age 73 years). Reliability was proved in terms of internal consistency, inter-item and item-scale correlations, and stability (test-retest procedure; n = 36; mean age 77 years). The responsiveness to change in oral health status was assessed by pre- and post-treatment comparison (n = 21; mean age 63 years). RESULTS: A German version of the GOHAI is presented. Convergent validity was sufficient (r = -0.76 compared with OHIP-14); group validity could be demonstrated for self-perceived need for treatment, chewing problems, number of own teeth, caries lesions present and dental status. The internal consistency was high (Cronbach's alpha = 0.92) as were inter-item and item-scale correlations, for which good homogeneity of the index was apparent. The test-retest correlation for the summary score was r = 0.84, single item correlations ranged from r = 0.36 to r = 0.89. The GOHAI sum score increased significantly after patients received new dentures, indicating responsiveness of the GOHAI to clinical change in the expected direction. CONCLUSIONS: The German version of the GOHAI had sufficient reliability, validity and responsiveness to be used as measure of oral health-related quality of life in cross-sectional and longitudinal studies of the elderly.

OBJECTIVES: The aim was to assess the prevalence of osteoarthrosis (OA) in the temporomandibular joint (TMJ) in a sample of older people by use of contrast agent-enhanced MRI. METHODS: 30 patients (73-75 years old) were drawn from a representative sample and were examined clinically. The shape of the condyle was assessed using gadolinium-enhanced MR images, which were evaluated by two independent raters. Statistical assessment was performed by using descriptive statistics, the chi(2) test and kappa statistics. RESULTS: Agreement between raters was excellent with respect to the presence/absence of OA (kappa = 0.8). Only one subject reported pain in a TMJ. Fine and/or coarse crepitus was not heard in any subject. MRI showed that 70% displayed signs of OA in at least one TMJ. There were no gender-related differences in the prevalence of OA (P > 0.05). CONCLUSION: Gadolinium-enhanced MRI showed that OA of the TMJ is common in older people (70%), although the prevalence of clinical signs of OA is very low.

Abstract The oxidative stability of five different oils was determined by Rancimat analysis with conductivity and chemiluminescence measurements for evaluation of the induction periods. Samples of oil, taken at intervals from the Rancimat apparatus, were used for chemiluminescence measurements. The chemiluminescence results were plotted vs. time, and the resulting curves were evaluated with a graphical tangential procedure in the same way as the curves of the Rancimat method (conductivity measurement). Induction periods of the oils assessed by Rancimat and chemiluminescence methods showed a significant linear correlation ( r =0.9865). The temperature dependence of the induction periods evaluated by chemiluminescence and by conductivity was investigated with walnut oil. A marked temperature dependence was observed for both.

Seeds of 14 different members of the family Brassicaceae were investigated with regard to their content and composition of glucosinolates by HPLC-UV/ESI-MS-MS coupling. The seeds were extracted with hot methanol/water (70:30 v/v) and the desulfoglucosinolates isolated by anion-exchange chromatography with solid-phase extraction columns. The desulfoglucosinolates were detected by UV and identified by ESI-MS/MS with the neutral loss method. Nineteen different glucosinolates were detected in the seeds with a wide range of contents (10-200 micromol/g) and a great variation in the composition.

Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

OBJECTIVES: The "Assessment of DSM-IV Personality Disorders (ADP-IV)" represents a 94-item questionnaire that allows for a categorical and dimensional assessment of the DSM-IV personality disorders. METHODS: Psychometric properties of the German ADP-IV were investigated in 400 psychotherapy outpatients and a community sample of 385 persons. The SCID-II interview and a standardised expert consensus rating were employed for the assessment of concurrent validity. RESULTS: The ADP-IV showed satisfactory reliability; the median Cronbach's alpha for the subscales was .76 (range .65-.87), the median retest reliability .79 (range .37-.88). Factor analysis revealed an 11-factor solution that explained 49.4% of the variance. The median correlation of the dimensional ADP-IV subscale scores with the SCID-II and the expert consensus ratings were .51 (range: .34-.72) and .44 (range: .27-.62), respectively. The kappas for the chance corrected agreement of categorical ADP-IV diagnoses with the SCID-II diagnoses and the expert ratings were .35 and .29 for any personality disorder and a median of .37 and .30 for the specific personality disorders. CONCLUSIONS: The ADP-IV shows satisfactory reliability and a validity that is comparable and partly superior to other self-rating instruments. The advantages of the instrument are its brevity, the inclusion of distress ratings, and the dimensional scoring that allows for the construction of detailed profiles of personality pathology. Moreover it is freely available in the internet: (http://zmkweb.uni-muenster.de/einrichtungen/proth/dienstleistungen/psycho/diag/index.html).

OBJECTIVE: The aim of this study was to investigate factors associated with the oral health-related quality of life (OHRQoL) of institutionalized elderly in Germany. MATERIAL AND METHODS: One-hundred-and-fifty-eight subjects from old people's homes were selected (mean 82.8 years). OHRQoL was measured using the Oral Health Impact Profile (OHIP). Denture characteristics (kind and age of denture, retention of removable denture, number of teeth in static occlusion) and general issues (age, gender, education level, and general pain status) were assessed. All factors were subjected to bivariate testing for their effects on the OHIP summary score (OHIP-SC) and to multivariate testing in subjects with removable dentures (n = 128); a linear regression model with backward elimination was used, with OHIP-SC as the dependent variable. RESULTS: In the context of other studies, a median OHIP-SC of 29 indicated highly impaired OHRQoL. According to the bivariate analysis, retention, age of denture, number of teeth in static occlusion, general pain status, and education all exhibited significant influence on OHIP-SC. In the final linear regression model, general pain status, education level, and retention of denture remained at a statistically significant level. The model explained 34% (R2 = 0.34) of the variance of the OHIP-SC. The kind of denture had no significant impact on OHIP-SC. CONCLUSIONS: In contrast to other groups, the kind of denture exhibited little impact on OHIP-SC for this highly specific collective. However, there were functional aspects of dentures which seemed to be important. Non-dental factors had a striking effect on OHRQoL.

This study deals with a three-point flexure test for the metal-ceramic bond involving geometrically simple specimens (alloy strips partly coated with ceramic) that can be fabricated with reasonable expenditure and sufficient reproducibility. The calculation of the stress distribution in such specimens with the aid of the finite-element method (FEM) is presented. The aim of this numerical analysis is: to investigate the stress distribution in a ceramometallic specimen with dimensions that, in a large number of experiments, have proven to lead to debonding at one end of the ceramic veneer instead of a crack in the middle of the veneer; and to assign a bond strength to the measured critical bending force that takes into account the influence of the Young's modulus of the alloy as well as a possible deviation of the thickness of the metal substrate from the standard value. Bond strength values of a variety of metal-ceramic combinations are demonstrated. These experimental results demonstrate the reproducibility of the test method as well as its sensitivity to diverse parameters. The presented method is proposed as an alternative to another flexure bond test nominated for international standard. In this test ceramometallic strips are bent over a rod to a 90 degrees angle of the specimen ends, subsequently flattened, and the fracture surface visually inspected for adherence of the ceramic to the alloy substrate along the predominant part of the middle third of the specimen. It is clear that such a test can at most deliver qualitative results.

BACKGROUND: We report on the study design and protocols of two randomized controlled trials (Acupuncture Randomized Trials = ART) that investigate the efficacy of acupuncture in the treatment of chronic low back pain and osteoarthritis of the knee, respectively. OBJECTIVE: To investigate whether acupuncture is more efficacious than (a) no treatment or (b) minimal acupuncture in the treatment of low back pain and osteoarthritis. DESIGN: Two randomized, controlled, multicenter trials with three treatment arms and a total follow-up time of 52 weeks. SETTING: 30 practitioners and outpatient units in Germany specialized in acupuncture treatment. PATIENTS: 300 patients will be included in each study. In the low back pain trial, patients will be included according to clinical diagnosis. In the osteoarthritis pain trial, patients will be included according to the American College of Rheumatology criteria. INTERVENTIONS: Patients are randomly assigned to receive either (1) semi-standardized acupuncture (150 patients), (2) minimal acupuncture at non-acupuncture points (75 patients), or (3) no treatment for two months followed by semi-standardized acupuncture (75 patients, waiting list control). Acupuncture treatment consists of 12 sessions per patient over a period of 8 weeks. MAIN OUTCOME MEASURE: The main outcome measure is the difference between baseline and the end of the 8-week treatment period in the following parameters: pain intensity as measured by a visual analogue scale (VAS; 0-100 mm) in the low back pain trial and by the Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC) in the osteoarthritis trial. OUTLOOK: The results of these two studies (available in 2004) will provide health care providers and policy makers with the information needed to make scientifically sound assessments of acupuncture therapy.

In a controlled study, the effects of amitriptyline compared with that of a placebo in cats suffering from idiopathic Feline Lower Urinary Tract Disease (FLUTD) have been investigated. Thirty-six animals were selected by veterinary practitioners and treated with a placebo or 10mg amitriptyline once daily. All animals received concomitant antibiotic treatment. A total of 24 cats were included in the final assessment of the results. The severity of symptoms before and after treatment were compared between groups and showed no significant difference. Results indicated that the 7-day course of 10mg amitriptyline was not effective in the treatment of idiopathic FLUTD. Thus, it is considered not to be beneficial as a short-term therapy where the therapeutic results depend on peripheral effects of the drug. Long-term effects may be expected 4 or more weeks after the start of therapy and need to be further investigated.

OBJECTIVE: To examine outcome data for cats and dogs with congenital internal hydrocephalus following treatment via ventriculoperitoneal shunting to determine treatment-associated changes in neurologic signs, the nature and incidence of postoperative complications, and survival time. DESIGN: Retrospective multicenter case series. ANIMALS: 30 dogs and 6 cats with congenital internal hydrocephalus (confirmed via CT or MRI). PROCEDURES: Medical records for dogs and cats with internal hydrocephalus that underwent unilateral ventriculoperitoneal shunt implantation from 2001 through 2009 were evaluated. Data collected included the nature and incidence of postoperative complications, change in clinical signs following surgery, and survival time. To compare pre- and postoperative signs, 2-way frequency tables were analyzed with a 1-sided exact McNemar test. RESULTS: 8 of 36 (22%) animals developed postoperative complications, including shunt malfunction, shunt infection, and seizure events. Three dogs underwent shunt revision surgery. Thirteen (36%) animals died as a result of hydrocephalus-related complications or were euthanized. Following shunt implantation, clinical signs resolved in 7 dogs and 2 cats; overall, 26 (72%) animals had an improvement of clinical signs. After 18 months, 20 animals were alive, and the longest follow-up period was 9.5 years. Most deaths and complications occurred in the first 3 months after shunt placement. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that ventriculoperitoneal shunt implantation is a viable option for treatment of dogs or cats with congenital hydrocephalus. Because complications are most likely to develop in the first 3 months after surgery, repeated neurologic and imaging evaluations are warranted during this period.

AIM: At the annual meeting of German dentists in Frankfurt am Main in 2013, the Working Group for the Advancement of Dental Education (AKWLZ) initiated an interdisciplinary working group to address assessments in dental education. This paper presents an overview of the current work being done by this working group, some of whose members are also actively involved in the German Association for Medical Education's (GMA) working group for dental education. The aim is to present a summary of the current state of research on this topic for all those who participate in the design, administration and evaluation of university-specific assessments in dentistry. METHOD: Based on systematic literature research, the testing scenarios listed in the National Competency-based Catalogue of Learning Objectives (NKLZ) have been compiled and presented in tables according to assessment value. RESULTS: Different assessment scenarios are described briefly in table form addressing validity (V), reliability (R), acceptance (A), cost (C), feasibility (F), and the influence on teaching and learning (EI) as presented in the current literature. Infoboxes were deliberately chosen to allow readers quick access to the information and to facilitate comparisons between the various assessment formats. Following each description is a list summarizing the uses in dental and medical education. CONCLUSION: This overview provides a summary of competency-based testing formats. It is meant to have a formative effect on dental and medical schools and provide support for developing workplace-based strategies in dental education for learning, teaching and testing in the future.

In order to assess the actual load on front teeth and tooth supportive tissue during brass instrument playing, a measuring system was developed permitting simultaneous recordings of mouthpiece forces and incisor deflections. By the application of strain gauges, the mouthpiece itself was converted into an extra-oral force transducer, whilst an intra-oral metal appliance similar to a removable partial denture served as the base for strain gauge transducers sensing incisor displacements. The measurements only slightly affected the handling of the instruments under examination (trumpet, french horn, tenor horn, and tuba) and yielded the following average results for three to five players per instrument: peak force values were in the range of 29 N (tuba) to 50 N (trumpet), and the respective peak displacements were 43 microns and 100 microns.

OBJECTIVE: This exploratory study evaluated patients' reasons for entering a complementary (alternative) medicine hospital by ranking 15 medical and psychosocial factors that were thought to influence this choice. SUBJECTS AND OUTCOME MEASURES: Two hundred patients (200) from two complementary hospitals, one focusing on Traditional Chinese Medicine and one on the Western type of complementary medicine, completed an extensive questionnaire at the beginning of their inpatient treatment. The questionnaire covered personal background; disease parameters; attitude towards conventional medicine; previous experience with, and knowledge of, complementary therapies; expectations concerning the forthcoming treatment; health-related habits; personality traits; and social support. RESULTS: Optimistic attitudes towards treatment and a positive appraisal of alternative doctors were frequently stated reasons (80%), as was the disease severity (long duration: 86%; acute progression or imminent surgery: 70%). Previous successes with complementary therapies, however, ranked relatively low (53%). Negative opinions concerning conventional therapies and conventional doctors' treatments were mentioned by 68% of the patients. Many patients felt themselves to be under considerable psychologic stress (74%). A majority (73%) was well informed about complementary therapies, and 65% were curious about the forthcoming therapies. Sixty-eight percent (68%) indicated good health behaviors. Fewer patients mentioned contemplative and/or religious attitudes (44%) or lack of social support (25%). Age primarily accounted for variations in the ranking weights of the two subgroups. The specific type of complementary medicine was of minor influence. In 14 out of 21 personality dimensions, the current patient group showed significant deviations from the healthy reference, which is in good agreement with findings from conventionally treated patients.

Abstract Different oilseeds, usable as renewable resources, are analyzed for their content of condensed tannins, glucosinolates, phytic acid and its degradation products as well as for sinapine, and the results are presented. Seeds of sunflower, flax, coriander, Euphorbia lagascae , iberic. dragon head, safflor, Camelina sativa , soy, mustard, hemp and rapeseeds are used. Apart from hemp, coriander and Euphorbia lagascae different cultivars or genotypes of each species are investigated. The variation of the results of each cultivar or genotype is shown. Tannins and phytic acid are found in different amounts in all oilseeds, whereas sinapine and glucosinolates are limited to seeds from species belonging to the plant family Brassicaceae.

BACKGROUND: In a retrospective study, risk factors for complications after the bridging of mandibular defects using reconstruction plates were reviewed. Especially the loosening of the plate-screw-mandible complex should be analyzed with a finite element model in order to reduce plate complications in future. PATIENTS AND METHODS: We examined 60 patients who underwent a treatment with reconstruction plates after tumor resection during a period of 10 years. The problem of screw loosening was additionally reviewed by means of a finite element study, and a model for the loosening process was developed. RESULTS: Our postoperative examination showed that 26 patients suffered from complications that required an early removal of the plate. These complications were oral or extraoral plate exposures, the looseness of screws with or without plate displacement, and plate fractures. Thereby, we noticed that maxillary and mandibular areas of opposing teeth, the size of the mandible defect, and the crossing of the orofacial midline are all risk factors for plate complications. On the basis of the finite element model, a modified arrangement of the screws was derived. Hence, a new type of resection plate was established. CONCLUSIONS: By repositioning the screw holes along the long axis of the plate, the transition from tensile force to torque force of the screws in the screw-plate-bone complex can be minimized. Thereby, the complication of screw loosening will be considerably reduced.