Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions.

OBJECTIVES: This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview. MATERIALS AND METHODS: A literature search across PubMed, Embase, and Cochrane Library informed the analysis. RESULTS: Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain. CONCLUSIONS: Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial. CLINICAL RELEVANCE: Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals.

Post-graduation career pathways: a nationwide survey among dental students in Germany.

OBJECTIVES: Oral and maxillofacial surgery (OMFS) has to compete with other specialties for the best candidates. With the upcoming change of generations (Z and Alpha) and the movement toward gender parity of dentistry, understanding changing preferences and misconceptions is essential. MATERIAL AND METHODS: An online survey was conducted by the German-Association-of-Oral-and-Maxillofacial-Surgery (DGMKG) across German dental schools. The survey collected demographic data, academic background, and career aspirations, with a focus on OMFS. The dental student survey results were compared to a survey given to OMFS Specialists. RESULTS: 637 dental students, mainly female (70%), from 30 German universities participated. 27% had defined career aspirations post-graduation, with self-employment and academia being popular choices. 67% were unsure. Specializations leaned towards restorative dentistry (41%), orthodontics (36%), and prosthodontics (31%). While 73% showed interest in surgical practices, 20% were attracted in specializing in OMFS. Of those averse to OMFS, 78% cited long training duration as the deterrent, 12% were put off by perceived unattractive working hours. Other reasons included negative undergraduate experiences, scarcity of part-time positions, and perceived inadequate earnings. CONCLUSION: Accurate data is crucial for career decisions. OMFS societies must proactively share accurate information and guide students. OMFS offers family-friendly hours, and while its training might be longer than dental specialties, it is on par with other surgical professions. CLINICAL RELEVANCE: Dental students consistently regard OMFS as commendable career path. To guarantee sustained OMFS expertise, it is imperative to nurture this interest through dedicated academic mentorship and innovative education, thereby solidifying their professional direction.

Antibacterial properties of marine algae incorporated polylactide acid membranes as an alternative to clinically applied different collagen membranes.

The reconstruction of bony defects in the alveolar crest poses challenges in dental practice. Guided tissue regeneration (GTR) and guided bone regeneration (GBR) procedures utilize barriers to promote bone regeneration and prevent epithelial growth. This study focuses on evaluating the antibacterial properties of marine algae-polylactic acid (PLA) composite membranes compared to commercially available collagen membranes. Marine algae (Corallina elongata, Galaxaura oblongata, Cystoseira compressa, Saragassum vulgare, and Stypopodium schimperi) were processed into powders and blended with PLA to fabricate composite membranes. Cytocompatibility assays using human periodontal ligament fibroblasts (n = 3) were performed to evaluate biocompatibility. Antibacterial effects were assessed through colony-forming units (CFU) and scanning electron microscopy (SEM) analysis of bacterial colonization on the membranes. The cytocompatibility assays demonstrated suitable biocompatibility of all marine algae-PLA composite membranes with human periodontal ligament fibroblasts. Antibacterial assessment revealed that Sargassum vulgare-PLA membranes exhibited the highest resistance to bacterial colonization, followed by Galaxaura oblongata-PLA and Cystoseira compressa-PLA membranes. SEM analysis confirmed these findings and revealed smooth surface textures for the marine algae-PLA membranes compared to the fibrous and porous structures of collagen membranes. Marine algae-PLA composite membranes show promising antibacterial properties and cytocompatibility for guided bone and tissue regeneration applications. Sargassum vulgare-PLA membranes demonstrated the highest resistance against bacterial colonization. These findings suggest that marine algae-PLA composite membranes could serve as effective biomaterials for infection control and tissue regeneration. Further in vivo validation and investigation of biodegradation properties are necessary to explore their clinical potential.

Navigational exploration of bony defect mimicking a solid lesion of the mandible compared to conventional surgery by young professionals.

INTRODUCTION: The aim of the current study was to evaluate the accuracy of resection a solid lesion in an acrylic lower jaw by young professionals using a dynamic computer-assisted surgical system comparted to conventional surgery technique. MATERIAL AND METHODS: Twenty students performed the removal of the lesion conventionally and twenty students did the operation with a dynamic computer-assisted surgical system. Both groups were compared regarding the defect size, operation time, and surgical complications. RESULTS: The defect size in the jaw was significant smaller with the navigated surgery (p < 0.001). Operation time was shorter without navigation system, but no significance was found (p = 0.137). Without navigation system three young professionals perforated the lingual cortex. DISCUSSION: Navigated surgery can immediately be used by young professionals and support young surgeons in everyday clinical practice, especially in operations with difficult anatomic situations.

Bone regeneration in critical-size defects of the mandible using biomechanically adapted CAD/CAM hybrid scaffolds: An in vivo study in miniature pigs.

The study aimed to analyze bone regeneration in critical-size defects using hybrid scaffolds biomechanically adapted to the specific defect and adding the growth factor rhBMP-2. For this animal study, ten minipigs underwent bilateral defects in the corpus mandibulae and were subsequently treated with novel cylindrical hybrid scaffolds. These scaffolds were designed digitally to suit the biomechanical requirements of the mandibular defect, utilizing finite element analysis. The scaffolds comprised zirconium dioxide-tricalcium phosphate (ZrO2-TCP) support struts and TCP foam ceramics. One scaffold in each animal was loaded with rhBMP-2 (100 µg/cm³), while the other served as an unloaded negative control. Fluorescent dyes were administered every 2 weeks, and computed tomography (CT) scans were conducted every 4 weeks. Euthanasia was performed after 3 months, and samples were collected for examination using micro-CT and histological evaluation of both hard and soft tissue. Intravital CT examinations revealed minor changes in radiographic density from 4 to 12 weeks postoperatively. In the group treated with rhBMP-2, radiographic density shifted from 2513 ± 128 (mean ± SD) to 2606 ± 115 Hounsfield units (HU), while the group without rhBMP-2 showed a change from 2430 ± 131 to 2601 ± 67 HU. Prior to implantation, the radiological density of samples measured 1508 ± 30 mg HA/cm³, whereas post-mortem densities were 1346 ± 71 mg HA/cm³ in the rhBMP-2 group and 1282 ± 91 mg HA/cm³ in the control group (p = 0.045), as indicated by micro-CT measurements. The histological assessment demonstrated successful ossification in all specimens. The newly formed bone area proportion was significantly greater in the rhBMP-2 group (48 ± 10%) compared with the control group without rhBMP-2 (42 ± 9%, p = 0.03). The mean area proportion of remaining TCP foam was 23 ± 8% with rhBMP-2 and 24 ± 10% without rhBMP-2. Successful bone regeneration was accomplished by implanting hybrid scaffolds into critical-size mandibular defects. Loading these scaffolds with rhBMP-2 led to enhanced bone regeneration and a uniform distribution of new bone formation within the hybrid scaffolds. Further studies are required to determine the adaptability of hybrid scaffolds for larger and potentially segmental defects in the maxillofacial region.

A technical feasibility study on adaptation of a microsurgical robotic system to an intraoperative complication management in dental implantology: perforated Schneiderian membrane repair using Symani® Surgical System.

The aim of the current study was to test the technical and clinical feasibility of a robotic system and investigate its potential in the surgical repair of perforated Schneiderian membranes using an ex-vivo porcine model. Eight pig heads were operated conventionally via a surgical loop and eight pig heads with the surgical robot "Symani® Surgical System" (Medical Microinstruments, Inc., Pisa, Italy). On each specimen, the Schneiderian membrane was incised over a length of 0.7 mm resembling a perforation. Operation time, the maximum sinusoidal pressure, the course of the pressure and the filling volume were measured. Additionally, adaptation of the wound edges has been detected via scanning electron microscopy. There were no significant differences for the pressure maximum (p = 0.528), for the time until the pressure maximum was reached (p = 0.528), or for the maximum filling volume (p = 0.674). The time needed for the suturing of the membrane via robotic surgery was significantly longer (p < 0.001). However, the scanning electron microscope revealed a better adaptation of the wound edges with robotic surgery. The technical feasibility of robot-assisted suturing of Schneiderian membrane laceration using the robotic system has been confirmed for the first time. No differences considering the pressure resistance compared to the conventional repair could be observed, but advantages in wound adaptation could be found with an electron microscope. Regarding the material and training costs and limited indications spectrum, robotic surgery systems still might not present financially feasible options in the daily dental practice yet.

Decontaminative Properties of Cold Atmospheric Plasma Treatment on Collagen Membranes Used for Guided Bone Regeneration.

Background cold atmospheric plasma (CAP) is known to be a surface-friendly yet antimicrobial and activating process for surfaces such as titanium. The aim of the present study was to describe the decontaminating effects of CAP on contaminated collagen membranes and their influence on the properties of this biomaterial in vitro. Material and Methods: A total of n = 18 Bio-Gide® (Geistlich Biomaterials, Baden-Baden, Germany) membranes were examined. The intervention group was divided as follows: n = 6 membranes were treated for one minute, and n = 6 membranes were treated for five minutes with CAP using kINPen® MED (neoplas tools GmbH, Greifswald, Germany) with an output of 5 W, respectively. A non-CAP-treated group (n = 6) served as the control. The topographic alterations were evaluated via X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). Afterward, the samples were contaminated with E. faecalis for 6 days, and colony-forming unit (CFU) counts and additional SEM analyses were performed. The CFUs increased with CAP treatment time in our analyses, but SEM showed that the surface of the membranes was essentially free from bacteria. However, the deeper layers showed remaining microbial conglomerates. Furthermore, we showed, via XPS analysis, that increasing the CAP time significantly enhances the carbon (carbonyl group) concentration, which also correlates negatively with the decontaminating effects of CAP. Conclusions: Reactive carbonyl groups offer a potential mechanism for inhibiting the growth of E. faecalis on collagen membranes after cold atmospheric plasma treatment.

Oral cancer awareness campaign in Northern Germany: successful steps to raise awareness for early detection.

PURPOSE: Oral cancer is an underestimated health problem, and its existence and the relevant prevention measures are not sufficiently known by the general population. The project thus aimed to develop, implement and evaluate an oral cancer campaign in Northern Germany, and to increase problem awareness on various levels: draw public attention to the tumour by media coverage increase awareness of early detection opportunities for the target group, and raise awareness of carrying out early detection measures by the professional groups involved. METHODS: For each level, a campaign concept was developed and documented in terms of content and timing. The identified target group was elderly educationally disadvantaged male citizens ≥ 50 years. The evaluation concept for each level included pre-, post- and process evaluations. RESULTS: The campaign was carried out from April 2012 to December 2014. The issue of awareness within the target group was significantly increased. Media coverage showed that regional media adopted the topic of oral cancer and placed it on their published agenda. Furthermore, the continuous involvement of the professional groups over the course of the campaign led to an increased awareness of oral cancer. CONCLUSION: The development of the campaign concept with a comprehensive evaluation showed that the target group was successfully reached. The campaign was adapted to the required target group and specific conditions, and was also designed to be context sensitive. It is, therefore, recommended that the development and implementation of an oral cancer campaign on a national level be discussed.

In Vitro Comparison of 2 Clinically Applied Biomaterials for Autologous Chondrocyte Implantation: Injectable Hydrogel Versus Collagen Scaffold.

OBJECTIVE: In autologous chondrocyte implantation (ACI), there is no consensus about used bioscaffolds. The aim of this study was to perform an in vitro comparative analysis of 2 clinically applied biomaterials for cartilage lesion treatment. DESIGN: Monolayer expanded human chondrocytes (n = 6) were embedded in a collagen scaffold (CS) and a hyaluronic acid-based hydrogel (HA). Cells were cultured in chondropermissive medium supplemented with and without interleukin-10 (IL-10) and bone morphogenetic protein-2 (BMP-2). Gene expression of chondrogenic markers (COL1A1, COL2A1, COL10A1, ACAN, SOX9) was detected via quantitative real-time-polymerase chain reaction (RT-qPCR). Biosynthesis of matrix compounds, cell viability, morphology as well as migration from surrounding native bovine cartilage into cell-free scaffolds were analyzed histologically. Adhesion of the material to adjacent cartilage was investigated by a custom-made push-out test. RESULTS: The shift of COL1/2 ratio toward COL2A1 was more pronounced in HA, and cells displayed a more spherical morphology compared with CS. BMP-2 and IL-10 significantly increased COL2A1, SOX9, and ACAN expression, which was paralleled by enhanced staining of glycosaminoglycans (GAGs) and type 2 collagen in histological sections of CS and HA. COL10A1 was not significantly expressed in HA and CS. Better interfacial integration and enhanced cell invasion was observed in CS. Push-out tests using CS showed higher bonding strength to native cartilage. CONCLUSION: HA-based hydrogel revealed a more chondrocyte-like phenotype but only allowed limited cell invasion, whereas CS were advantageous in terms of cellular invasion and interfacial adhesion. These differences may be clinically relevant when treating cartilaginous or osteochondral defects.

Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)-A Prospective Multicentric Cohort Study.

(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55-1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15-0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19-0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group.

Pronounced mediastinal emphysema after restorative treatment of the lower left molar-a case report and a systematic review of the literature.

This case report presents an iatrogenic induced mediastinal emphysema after restorative treatment of the lower left second molar, aimed to highlight the potential life-threatening consequences, and providing diagnostics and treatment concepts of complicated dental induced emphysema based on literature review. A 74-year-old female patient was admitted to the emergency department due to a fall on her shoulder. Additional finding was a significant swelling of the face and neck. In the computer tomography of the head, neck, and thorax, a humerus fracture and pronounced soft tissue emphysema from the infraorbital region to the mediastinum was detected. The patient reported that she had been treated by her dentist 4 days earlier. The treatment had to be discontinued after beginning of a pronounced swelling. Other reasons for the emphysema could be excluded out on an interdisciplinary teamwork. The patient was monitored as an inpatient for 5 days and received intravenous antibiotic therapy. This case report shows the rare complication of pronounced mediastinal emphysema after root canal treatment. Emphysema should always be a differential diagnosis of soft tissue swelling and, in case of doubt, a general medical presentation should be made.

Organic Bone Matrix Component Type I and V Collagen Are Not Destructed in Bisphosphonate-Associated Osteonecrosis of the Jaws.

Background and objectives: The investigation of the pathophysiology behind medication-related osteonecrosis (MRONJ) of the jaw mostly focuses on alterations in osteoclast and osteoblast cell activity, but changes in the organic and inorganic bone matrix have rarely been studied. The aim of this study was to investigate whether collagen, the main organic component of extracellular bone matrix, is destructed in osteonecrosis of the jaw secondary to antiresorptive medication. Material and methods: Bone samples of patients with MRONJ (n = 15, control group n = 3) were demineralized, and collagen fragments were separated from intact collagen pellets by ultrafiltration. The quantification of mature collagen cross-links hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in pellets and ultrafiltrates was performed by high-performance liquid chromatography (HPLC). The detection of hydroxyproline (Hyp) was carried out using a spectrophotometric assay. In addition, collagen chains were analyzed by sodium dodecylsulfate-polyacrylamide gel (SDS-PAGE). Results: The results revealed significantly higher concentrations of HP, LP and Hyp in pellet samples. In addition, there were no significant differences between samples from MRONJ patients and those of the control group. These results were paralleled by SDS- PAGE. Conclusion: These findings suggest that MRONJ does not involve the destruction of type I and V collagen molecules, in contrast to previously reported destruction by osteoradionecrosis.

Investigation of Topographical Alterations in Titanium-Zirconium-Alloy Implant Threads following Er:YAG Irradiation.

The aim of the current experimental study was to comparatively assess the surface alterations in titanium and titanium-zirconium alloy implants in terms of thread pitch topography after irradiation with an Er:YAG laser, which is recommended in the literature for its sterilizing effect in the treatment of contaminated implant surfaces. Roxolid® and SLA® (Sand-blasted, Large-grit, Acid-etched) implants from Straumann® company with the same macro topography were investigated. The surface treatment was carried out using a wavelength of 2940 nm, 60 s irradiation time, a frequency of 10 Hz, and energies between 120 mJ and 250 mJ. The alterations were quantitatively analyzed by conducting roughness analysis via white light interferometry and qualitatively using SEM images. Roxolid® could particularly maintain its surface topography at a level of 160 mJ. At an energy level of 250 mJ, the surface properties of the pitch could be significantly altered for the first time. Compared to the Standard Plus dental implants studied, no distinct removal of the material from the surface was detected. The alloy properties of Roxolid® confirm the manufacturer's statement in terms of stability and could offer advantages in peri-implantitis management if decontamination has been selected. However, as a part of a respective strategy, smoothening of a Roxolid® implant surface requires a significantly higher energy level compared to SLA-Standard® dental implants.

Learning Curve and Comparison of Dynamic Implant Placement Accuracy Using a Navigation System in Young Professionals.

The aim of the current study was to evaluate the learning curve and accuracy of implant placement by young professionals using a dynamic computer-assisted surgical system for dental implant placement. Ten students tried to place eight implants with a dynamic surgical system in predefined positions on two consecutive weekends, resulting in 160 implant placements in total. Postoperatively, the positions of the implants were scanned with an intraoral scanner and compared for deviations at the entry point, the apex, as well as angular deviations to the master model. The mean values of all measurements improved; statistical significance was found for the changes in the angle as well as for the position of the implants to the apex (p < 0.001). Furthermore, the young professionals indicated subjective improvement in handling the dynamic surgery system. Navigated surgical dental implant placement can be learned quickly and can support young professionals in everyday clinical practice, especially in difficult anatomic situations.

Effect of enriched bone-marrow aspirates on the dimensional stability of cortico-cancellous iliac bone grafts in alveolar ridge augmentation.

BACKGROUND: The objective of the current study was to assess the clinical and radiological outcomes following autologous grafting from the iliac crest treated with autologous stem cells in-situ to reduce the postoperative bone graft resorption rate. MATERIALS AND METHODS: The study group consisted of patients who underwent vertical augmentation of the jaws via bone grafts harvested from the iliac crest enriched with bone-marrow aspirate concentrates (stem cell group). The first control group (control) included 40 patients underwent a vertical augmentation with autologous bone grafts from the iliac crest. In the second control group, 40 patients received identical surgical procedure, whereas the autologous bone graft was covered with a thin layer of deproteinized bovine bone matrix and a collagen membrane (DBBM group). Clinical complications, implant survival, radiological assessment of the stability of the vertical height and histological evaluation at the recipient site have been followed up for 24 months postoperatively. RESULTS: No differences in terms of implant survival were observed in the groups. In the stem cell group, the resorption after 4-6 months was 1.2 ± 1.3 mm and significantly lower than the resorption of the control group with 1.9 ± 1.6 mm (P = 0.029) (DBBM group: 1.4 ± 1.2 mm). After 12 months, the resorption of the stem cell group was 2.1 ± 1.6 mm and significantly lower compared to the control group (4.2 ± 3.0 mm, P = 0.001) and DBBM group (resorption 2.7 ± 0.9 mm, P = 0.012). The resorption rate in the second year was lower compared to the first year and was measured as 2.7 ± 1.7 mm in the stem cell group (1-year bone loss in the time period of 12-24 months of 0.6 mm compared to 2.1 mm in the first 12 months). The resorption was significantly lower compared to the control group (4.7 ± 2.9 mm; P = 0.003, DBBM group: 3.1 ± 0.5 mm, P = 0.075). CONCLUSIONS: Autologous bone-marrow aspirate concentrate could enhance the dimensional stability of the bone grafts and improve the clinical standard of complex reconstruction of the alveolar ridge. Even though the intraoperative cell enrichment requires an additional equipment and technical specification, it represents an alternative method for in-situ regeneration by osteogenic induction with a contribution of a manageable cost factor.

Robot-assisted scaffold implantation and two-stage flap raising of the greater omentum for reconstruction of the facial skeleton: Description of a novel technique.

BACKGROUND: Bone regeneration in the greater omentum is a promising strategy in facial skeleton reconstruction. This feasibility-study aims to perform robot-assisted scaffold implantation and second-stage flap raising. METHODS: Firstly, scaffolds were implanted into the greater omentum using the da Vinci Xi surgical system or conventional technique in five miniature pigs, respectively. After 3 months a free flap including the gastrocolic vascular pedicle was harvested and procedures were evaluated. RESULTS: The average operation time was 59.2 min for open surgery and 73.8 min for robot-assisted surgery. The average incision length of open surgery was 11.6 cm. Both techniques led to successful scaffold implantation without any complication. In all cases the scaffolds were integrated as intended and resulted in bone formation. CONCLUSIONS: Current study demonstrated that the implantation of scaffolds into the greater omentum and flap harvesting using da Vinci Xi surgical system is a promising minimally-invasive approach in regenerative surgery.

In-vitro assessment of the efficiency of cold atmospheric plasma on decontamination of titanium dental implants.

BACKGROUND: The aim of the current study was to comparatively assess the efficiency of three different adjunctive therapy options (cold atmospheric plasma, [CAP], photodynamic therapy [PDT] and chemical decontamination via 35% phosphoric acid gel [PAG]) on decontamination of titanium implant surfaces in-vitro. MATERIALS AND METHODS: Implants were inserted in concavities of four mm in depth mimicking a bone defect at the implant recipient site. In each model, two implants were inserted in the fourth and one implant in the third quadrants. After contamination with E. faecalis, the first group has been treated with CAP for 3 min, the second group with 35% PAG (and the third group with PDT. After treatment, quantification of bacterial colonization was assessed by quantification via colony forming units and qualitatively by fluorescence microscopy and scanning electron microscopy. RESULTS: With a mean value of 1.24 × 105 CFU/ml, the CAP treated implants have showed the least microorganisms. The highest number of CFU was found after PDT with mean value of 8.28 × 106 CFU/ml. For the implants that were processed with phosphoric acid, a mean value of 3.14 × 106 CFU/ml could be detected. When the groups were compared, only the CAP and PDT groups differed significantly from each other (p = 0.005). CONCLUSION: A complete cleaning of the micro-textured implant surface or the killing of the bacteria could not be achieved by any of the investigated treatment options, thus bacteria in the microstructure of the titanium surface cannot be completely reached by mechanical and physico-chemical processes. CLINICAL RELEVANCE: The main goal of the adjunctive peri-implantitis treatment is the decontamination of the implant surface. However, there is still an ongoing need to define the most appropriate adjunctive therapy method. Due to its antimicrobial effects, CAP combined with mechanical debridement could be a feasible treatment modality in the management of peri-implantitis.

Evaluation of prevention behaviour and its influencing factors with respect to cancer screening.

PURPOSE: Every year, about 4.6 million people are diagnosed with cancer in Europe. However, based on preclinical changes and using appropriate examination procedures certain cancers can be detected in symptom-free patients at an early stage and treatment initiated. In Germany, various cancer screening examinations are currently offered to the relevant age groups and sexes free of charge. Participation rates are affected by a number of factors and barriers. The study aimed at identifying potential obstacles and barriers to uptake, taking into account demographic and socio-economic variables. MATERIALS AND METHODS: Data collection was conducted in the context of routine examination appointments at the City of Kiel Occupational Health Department from September 2013 to September 2014 using an anonymised questionnaire. In addition to recording socio-demographic data and tobacco consumption, the questionnaire also catalogued participation in statutory health insurance cancer screening examinations using the "stages of change" from the Transtheoretical Model. Eight potential barriers to participation were recorded. RESULTS: The results are based on 718 completed questionnaires. It was found that women, older age, and non-smoking status were associated with a higher probability of participating in cancer screening. It was also found that various barriers affecting (regular) participation were perceived significantly different according to the individual stages of change. This influence of the stages was moderated by gender. CONCLUSION: The results showed interesting trends in the different barriers and how they are influenced by socioeconomic factors and the stages of change. Especially the stages require different gender-specific approaches to mobilisation for cancer screening.

Early detection of oral cancer: a key role for dentists?

PURPOSE: The majority of suspected malignant changes in the oral mucosa are detected by dentists in private practice. Statements regarding the effectiveness of visual examination of the oral cavity for early detection are not necessarily transferable between different health care systems. Our clinical-epidemiological and methodological aim was thus to conduct a prospective regional study in dental practices under everyday conditions, assess the frequency and type of oral mucosal changes, and evaluate the dental examination methodology. METHODS: A prospective observational study was conducted, combining a feasibility study of early detection of oral cancer and its documentation with phase I 'modelling' to conceptualize complex interventions in health services research. Dentists in private practice continuously recruited patients over 6 months and used two different sheets for the documentation of suspicious lesions. Statistical analysis involved descriptive statistics and tests for differences (Welch test) or association (Chi-squared test). RESULTS: Twenty-five dentists (mean age: 50 years, 24% females) participated in this study. Eleven dentists achieved the overall aim of recruiting 200 patients. Around 4200 patients (mean age: 52 years, 57.5% females) participated. The prevalence of suspicious lesions was 8.5%. CONCLUSION: It became apparent that a study in cooperation with dentists in private practice to generate clinical-epidemiological data on the early detection of oral mucosal lesions under everyday conditions can be carried out successfully. Further studies with a corresponding level of evidence should be carried out to be able to draw conclusions about the effectiveness of the early detection measure under everyday practice conditions.