A survey on German dentists regarding the management of craniomandibular disorders.

The purpose of the present investigation was to identify the most frequent therapies and, in particular, the prescription patterns for occlusal splints for the management of craniomandibular disorders (CMDs) used by German general dentists and specialists. Additionally, the knowledge and opinion of the practising dentists were examined. All active members of the statutory dental insurance providers of the German North Rhine (n = 5,500) and the Westphalia-Lippe area (n = 4,984) were surveyed with a questionnaire by mail. Results indicated that occlusal splints were the first-choice therapy followed by physiotherapy and occlusal equilibration. In the preceding year, both general dentists and specialists made 30 occlusal splints on average. With regard to high-quality evidence-based recommendations, some statistically significant discrepancies between general dentists and specialists were detected. On the basis of the present data, it seems useful to consider intensifying the topic of CMDs and orofacial pain in future undergraduate dental curricula and in postgraduate training.

Induction of osteogenic markers in differentially treated cultures of embryonic stem cells.

BACKGROUND: Facial trauma or tumor surgery in the head and face area often lead to massive destruction of the facial skeleton. Cell-based bone reconstruction therapies promise to offer new therapeutic opportunities for the repair of bone damaged by disease or injury. Currently, embryonic stem cells (ESCs) are discussed to be a potential cell source for bone tissue engineering. The purpose of this study was to investigate various supplements in culture media with respect to the induction of osteogenic differentiation. METHODS: Murine ESCs were cultured in the presence of LIF (leukemia inhibitory factor), DAG (dexamethasone, ascorbic acid and beta-glycerophosphate) or bone morphogenetic protein-2 (BMP-2). Microscopical analyses were performed using von Kossa staining, and expression of osteogenic marker genes was determined by real time PCR. RESULTS: ESCs cultured with DAG showed by far the largest deposition of calcium phosphate-containing minerals. Starting at day 9 of culture, a strong increase in collagen I mRNA expression was detected in the DAG-treated cells. In BMP-2-treated ESCs the collagen I mRNA induction was less increased. Expression of osteocalcin, a highly specific marker for osteogentic differentiation, showed a double-peaked curve in DAG-treated cells. ESCs cultured in the presence of DAG showed a strong increase in osteocalcin mRNA at day 9 followed by a second peak starting at day 17. CONCLUSION: Supplementation of ESC cell cultures with DAG is effective in inducing osteogenic differentiation and appears to be more potent than stimulation with BMP-2 alone. Thus, DAG treatment can be recommended for generating ESC populations with osteogenic differentiation that are intended for use in bone tissue engineering.

[Evaluation of hyperbaric oxygen therapy in treatment of patients with osteomyelitis of the mandible]. / Hyperbare Sauerstofftherapie bei Unterkiefer-Osteomyelitis.

BACKGROUND: Chronic osteomyelitis of the jaw is a relapsing disease with multiple treatment strategies described in the literature. Hyperbaric oxygen therapy is one of them. The purpose of this study was to evaluate the clinical outcome of hyperbaric oxygen therapy in these patients. METHOD: All patients with a chronic osteomyelitis of the mandible who received in our department hyperbaric oxygen therapy between 2000 and 2004 were included in this study. The clinical outcome (lack of symptoms e.g. pain, swelling, etc.) was the pivotal evaluation parameter. All patients were divided in three groups according to their medical history. Group 1: All patients with osteomyelitis of the mandible, who received no treatment before. Group 2: All patients with one local relapse, who received only antimicrobial treatment. Group 3: Patients with at least one local relapse after antimicrobial and surgical treatment. RESULTS: 27 patients were evaluated in this study. Seven out of 13 patients in group 1 were relapse free after performing 40 hyperbaric oxygen therapies. However, only 4 of 9 patients in group 3 were relapse free after treatment. In group 2 the hyperbaric oxygen therapy was successful particularly in the younger patients (3 of 4). CONCLUSION: Adjuvant hyperbaric oxygen therapy was successful in the treatment of patients with chronic recurrent osteomyelitis of the mandible. Therefore, it is an treatment option which can avoid ablative surgery in some cases.