Neurophysiologic and long-term effects of clinical hypnosis in oral and maxillofacial treatment--a comparative interdisciplinary clinical study.

This prospective comparative clinical study evaluated the effectiveness of clinical hypnosis and its long-term effect in oral and maxillofacial treatment. A total of 45 highly anxious and nonanxious subjects were evaluated by subjective experience and objective parameters. Parameters were EEG, ECG, heart rate, blood pressure, blood oxygen saturation, respiration rate, salivary cortisol concentration, and body temperature. During and subsequent to the operative treatment, hypnosis led to a significant reduction of systolic blood pressure, and respiration rate and to significant changes in the EEG. The subjective values of the parameters evaluated existing anxiety mechanisms and patterns and possible strategies to control them, whereas the objective parameters proved the effectiveness of hypnosis and its long-term effect.

Implant therapy following liver transplantation: clinical and microbiological results after 10 years.

BACKGROUND: The number of immunocompromised patients is increasing as a consequence of successful organ transplantation. Placing dental implants in these patients has been questioned because of their increased risk for infections. The 10-year follow-up data of a 71-year-old liver transplant recipient with long-term immunosuppressive therapy is reported. Six months after liver transplantation, two interforaminal implants were inserted in the edentulous mandible, and an overdenture using non-rigid telescopic attachments was fabricated 3 months later. METHODS: Oral clinical parameters included the modified plaque index, sulcus fluid flow rate, modified bleeding index, probing depth, distance implant mucosa, attachment level, width of the keratinized mucosa and mobility values. The distance implant bone (DIB) was determined on digital panoramic radiographs. The levels of eight periodontal marker organisms were established using DNA probe technology. Additionally, swabs of the edentulous oral mucosa were taken for microbiological culture and antimicrobial resistance testing. RESULTS: The peri-implant parameters were within normal ranges indicating a stable osseointegration with moderate vertical bone loss. Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Campylobacter rectus, and Treponema denticola were not detected. Low levels of Porphyromonas gingivalis, Fusobacterium nucleatum, and Eikenella corrodens were found. Prevotella intermedia was the only bacterium with a level higher than 10(4). The mucosal swabs indicated the presence of an abundant normal oral flora, including Escherichia coli and Candida albicans. The antibiogram revealed multiple resistance to antibiotics. CONCLUSION: This case report suggests that immunocompromised patients can be successfully rehabilitated with dental implants.

Interforaminal implant therapy using a split skin graft--treatment outcome after 13 years.

In implant patients who have extended soft tissue deficiencies, split skin grafts have been performed for the prevention of peri-implant inflammation. The aim of this investigation was to assess a patient who received 2 interforaminal implants and a split skin graft 13 years prior. In addition to clinical, mycologic, and radiographic examinations, the condition of the split skin graft was evaluated using histologic analysis of 3 punch biopsies taken from the mucosa, grafted area, and border between both areas. The implants were found to have an overall good clinical condition. Fungal infection was not present. The histologic analysis revealed inflammation-free mucosal and submucosal tissue in all samples. In the area of the skin graft, the mucosa was not keratinized and showed an increased thickness of the submucosal connective tissue. For the patient under examination, an acceptable level of oral rehabilitation was achieved using a split skin graft. The follow-up investigation showed stable conditions for both the implants and the graft.

Pilot study on the psychologic evaluation of prosthesis incompatibility using the SCL-90-R scale and the CES-D scale.

PURPOSE: The aim of this pilot study was to evaluate and determine psychogenic aspects of prosthesis incompatibility by psychologic tests that define the (psychogenic) prosthesis incompatibility as a psychologic disorder. The patients' complaints with the restorations included taste disorders, odynophagia, pain sensations, and functional and esthetic dissatisfaction. MATERIALS AND METHODS: The study cohort comprised 83 patients with complete dentures fabricated according to a standardized protocol. A dental history questionnaire was used to evaluate whether the patients had adapted to their dentures 6 months after incorporation. Twelve patients with suspected psychogenic prosthesis incompatibility and a group of 24 randomly selected control subjects were evaluated by application of the psychologic tests Symptom Checklist-90-R (SCL-90-R) and the Center of Epidemiological Studies Depression Scale (CES-D). RESULTS: When compared with the control group, patients with suspected psychogenic dental prosthesis incompatibility showed statistically significant differences in the CES-D cumulative values (P = .015) and the SCL-90-R values Global Severity Index (P = .024) and Positive Symptom Distress Index (P = .049). CONCLUSION: This was the first documented study to use the SCL-90-R and CES-D scales on patients with suspected psychogenic dental prosthesis incompatibility with nonadaptation 6 months after incorporation. Adaptation problems were ruled out as a possible cause. Using the SCL-90-R and CES-D, it was possible to make a reliable initial diagnosis of the psychosomatic clinical situation regarding psychogenic prosthesis incompatibility. The results have direct implications on socioeconomic and forensic consequences for diagnosis and treatment by a dental clinician.