Relapses in Illicit Drug Use Among Probationers: Results in a Risk Group of Public Health Services in Bavaria.

Objective: We aimed to identify in this study time trends of relapses in the illicit consumption of narcotics in a special at-risk population of former drug users under a public health perspective. Methods: In a pooled dataset of 14 consecutive calendar years (2006-2019), the use of seven different narcotic substances was studied in 380 persons with a total of 2,928 urine samples which were analyzed using a valid marker system for narcotic residues. Results: During the entire observation period, the relapse rate for cannabinoids and opiates was the highest despite abstinence requirements. It was noticeable that the relapses across all narcotics groups occurred primarily during the first 3 years of the probation period (90%) with a decrease in illegal consumption during the following years of the observation period. Conclusion: Special attention should be paid to probationers at the beginning of the probation period to develop more effective prevention strategies for substance abstinence by all involved actors in public health services.

Irregularities below the enamel-dentin junction may predispose for fissure caries.

This study investigated the structure of the fissure fundus on occlusal surfaces with respect to the detection of possible irregularities below the enamel-dentin junction (EDJ). Occlusal surfaces were examined by micro-computed tomography (µCT). In total, 203 third molars with clinically sound occlusal fissures or non-cavitated lesions were selected. All specimens were scanned with µCT. Subsequently, each tooth was sectioned, and each slice was investigated by stereomicroscopy. In 7 of 203 molars (3.4%), demarcated radiolucencies below the EDJ were detected by µCT. These defects were obviously of non-carious origin, because the µCT images revealed no gradient of demineralization in the dentin. In all cases, a direct pathway between the oral cavity and the dentin was evident. The comparison of the µCT sites with conventional histological images also revealed defects in the dentin. These results demonstrate that demarcated radiolucencies below the EDJ may not necessarily be caries lesions according to µCT images and may be classified as possible developmental irregularities. To avoid misinterpreting µCT data, dental researchers should carefully consider this condition when analyzing µCT images. The clinical significance of this finding is that these defects may predispose molar teeth to early-onset caries in occlusal pits and fissures.

[Multiple tooth resorption in an Italian greyhound]. / Résorptions Dentaries Multiples Chez un Lévrier Italien.

An Italian greyhound was presented three times during a two-year period for dental prophylaxis due to periodontal disease. Clinical examination revealed lesions on several teeth. Radiographs revealed extensive resorptive root lesions. On histological examination, the presence of odontoclasts and signs of boney remodeling of the roots confirmed the resorptive nature of the lesions. Given the extent of the lesions, and poor prognosis with conservative treatment alone, teeth affected by the most severe resorption were extracted at each visit using a flap technique combined with alveolar vestibular osteotomy. Dental resorptive lesions are rarely detected in the dog but may be more frequent than previously thought. The routine use of dental radiographs can be used to reveal these lesions in the dog.

Oral examination and radiographic evaluation of the dentition in wild cats from Namibia.

Feline tooth resorption has been widely reported in domestic cats and sporadically described in other felidae. The goal of the present study was to determine the prevalence of tooth resorption and to report other dental problems in a population of wild felidae. Observations of dental disorders and anomalies were made in skulls from 73 wild felidae (cheetahs, leopards, caracals, African wildcats, and lions) originating from Namibia. In addition, radiographs were taken in 43 cases to determine signs of bone and root pathology. Radiographs showed varying stages of tooth resorption in 16.0% of the specimens. Other dental anomalies found included fused teeth, supernumerary roots, or missing teeth. The prevalence of dental resorption in wild felidae was lower than reported in the domestic cat.

Associations between obesity and developmental functioning in pre-school children: a population-based study.

OBJECTIVE: To examine associations between obesity and impairment in developmental functioning in a general population sample of pre-school children. METHOD: Standardized medical examinations were conducted in nine consecutive cohorts of male and female children (n=9415) aged between 4.4 and 8.6 years (mean=6.0, s.d.=0.37) residing in the Lower Bavaria region of Germany. Tests designed to assess performance in subdivisions representing four broad developmental domains, namely, motor development, speech development, cognitive development and psycho-social development, were completed by all participants. RESULTS: Boys had significantly higher rates of impairment than girls. The prevalence of obesity in boys was 2.4%, whereas in girls it was 4.3% (chi (2)=21.51, P< 0.01). After controlling for age, gender, year of recruitment and other potential covariates, the prevalence of impairment in gross motor skills was higher among obese male children than normal-weight male children (adjusted odds ratio=1.76, 95% confidence interval (CI)=1.02, 3.01, P< 0.05), whereas the prevalence of impairment in the ability to focus attention was higher in obese female children than normal-weight female children (adjusted odds ratio=1.86, 95% CI=1.00, 3.44, P< 0.05). CONCLUSIONS: The findings suggest that gender-specific associations between obesity and impairment in specific aspects of developmental functioning may be evident in younger children.

Detection of approximal caries with a new laser fluorescence device.

The laser device DIAGNOdent developed for the detection of occlusal caries has limited value on approximal surfaces. The aim of this study was to develop and to test a new laser fluorescence (LF) device for the detection of approximal caries. Light with a wavelength of 655 nm was transported to the approximal surface using two different sapphire fibre tips. Seventy-five teeth were selected from a pool of extracted permanent human molars, frozen at -20 degrees C until use. Before being measured, they were defrosted, cleaned and calculus was removed with a scaler. The molars were set in blocks simulating the contact area of adults. Bitewing radiographs were obtained using Kodak Insight films. After two independent assessments with the new LF device, the teeth were histologically prepared, and assessed for caries extension. Using the laser, specificity values for D1 threshold (outer half of enamel), D2 threshold (inner half of enamel), D3 threshold (dentine) ranged between 0.81 and 0.93, sensitivity between 0.84 and 0.92 with no difference between the two tips. Bitewing radiography showed an inferior performance compared to LF (p<0.05). Intraex aminer reproducibility was high (kappa>.74). The new LF system might be a useful additional tool in detecting approximal caries. Because of its good reproducibility, it could be used to monitor caries regression or progression on approximal surfaces.

Observations of the periodontal ligament and cementum in cats with dental resorptive lesions.

The etiology of feline dental resorptive lesions is unknown, but some evidence suggests that interactions between components of the periodontium may be initiating factors in the development of these lesions. In the present study, 22 clinically normal teeth were harvested from 7 cats. The teeth and periodontium were radiographed and examined histologically. In addition, 14 of the 22 teeth were examined histometrically. Two teeth were histologically normal with an open apical foramen and two were normal with a closed apical foramen. Histological evidence of periodontal ligament degeneration without cementum resorption was observed in 8 teeth, and varying degrees of cementum resorption were observed in 10 teeth. Mandibular molar and premolar teeth had distal drift, and mandibular canine teeth had mesial drift. Alterations in the periodontal ligament may represent a preclinical stage of dental resorption.

Degradation of hydroxyapatite coating on a well-functioning femoral component.

We carried out a histological study of a proximally hydroxyapatite (HA)-coated femoral component, retrieved after 9.5 years of good function. The HA coating had completely degraded. Bone was in direct contact with the titanium surface in all the areas which had been coated, with no interposing fibrous tissue. There were no signs of particles, third-body wear, adverse tissue reactions or osteolysis. Bone remodelling was evident by the presence of resorption lacunae; tetracycline labelling showed bone laid down six years after implantation. The loss of the HA-coating had no negative effect on the osseo-integration of the stem. We conclude that the HA coating contributes to the fixation of the implant and that its degradation does not adversely affect the long-term fixation.

[Immunisation rates of routine vaccinations for school starters as a quantitative measure in the vaccination behaviour]. / Durchimpfungsraten von Routineimpfungen bei einschulungspflichtigen Kindern als quantitatives Mass für das Impfverhalten - Eine retrospektive Langzeitbeobachtung über zehn Jahre -

The aim of this retrospective long-term investigation was to compare the recommended routine vaccinations for school starters in the region of Dingolfing-Landau, recording the results separately by birth years and comparing these with one another. It was to show to what extent changes in the quantitative measures in the vaccination behaviour were recorded over a period of one decade, respectively to what extent the current recommendations of any one time of the STIKO (Permanent Vaccination Commission of the Robert Koch-Institute) were reflected within each age group. For this purpose during the annual standardised examinations of school starters the rates of vaccinations were recorded according to the various birth years and sex, determined and anonomously evaluated. It was found that of the total eleven examined birth years the vaccinations in series of BCG was reduced continually from a commencing 50 % plus to under 10 %. Regarding vaccinations against diphtheria, tetanus and polio the frequency for the total examined period commenced at a rate of under 90 %, increasing to over 90 % for the birth years of 1989 and beyond. No child of the birth year of 1984 was completely vaccinated against HiB, whereas the rate of vaccinations rose relatively quickly so that by the birth year 1994 over 90 % of the school starters were completely immunised against this infectious disease. As far as the pertussis and MMR vaccinations were concerned the rate at the beginning of the observation period was between 40 % and 60 %, increasing continually in the following period to over 80 %. By the middle 'eighties hardly any school starters had been vaccinated against hepatitis B, whereas, in the last five examined birth years the rate increased relatively quickly to 64 % maximum. At the beginning of the observed period nearly every fifth school starter had, age related, complete vaccination protection, in respect of the then valid STIKO recommendations. At the end of this decade this applied only to every twelfth child. Due to the high rates of participation of school starters examinations carried out by the Public Child and Youth Health Service it is possible to determine the vaccination rates of children as it relates to the routine vaccinations carried out over a longer period and on a topical basis. As a result the vaccination behaviour, respectively the willingness of a relevant target group during that period can be shown quantitatively. As the investigations of the RKI (Robert Koch-Institute) have shown, the share of the strict opponents of vaccinations is merely between 1.5 % and 5 % resulting in the necessity for intensive educational work and the development of effective vaccination strategies which are needed in order to stabilise the rates of vaccinations, respectively to meet epidemiological requirements at a high level and to further improve the present rate.

[Immunization monitoring of students starting school: a regional contribution from the Bavaria district]. / Impfmonitoring bei Schulanfängern: Ein Regionalbeitrag aus einem Landkreis Bayerns.

The aim of these sectional studies was to find out current mass immunisation rates of school beginners. The study was carried out in the administrative district of Dingolfing-Landau in 1999, also to examine to what extent the recommendations to the STIKO (Established Immunisation Committee at the Robert Koch-Institute) for the corresponding age-group had been complied with. To this end, the vaccination documents submitted at the medical examination were inspected, the given data recorded in a standardised way and subsequently rendered anonymous. According to the available results the mass immunisation rates for diptheria, tetanus and polio met the infection epidemiology requirements by over 90%. The HiB, MMR and whooping cough vaccinations were in on the average 80% for mass immunisation, which no longer meets the epidemiological requirements. BCG inoculation was only given to every tenth child in the relevant age group. A positive aspect was the comparatively high immunisation rate of almost 50% on hepatitis B immunisation. Only one child in twenty in the relevant age group had the full immunisation protection recommended by STIKO. Due to the great acceptance and willingness to co-operate on the part of the parents/legal guardians the review of the immunisation status through the Childrens and Young People's Public Health Authority (KJGD) made it possible to establish the current mass immunisation rate for children of one birth year. In this way, it will be possible by means of relevant immunisation recommendations and immunisation strategies to close the immunisation gaps and raise the mass immunisation rates.

A retrospective study of dental conditions of captive brown bears (Ursus arctos spp.) compared with free-ranging Alaskan grizzlies (Ursus arctos horribilis).

The teeth of 63 skulls of brown bears (Ursus arctos spp.) that had lived in the Bernese bear pit between 1850 and 1995 were examined and radiographed for occlusion, loss of teeth, calcified dental plaque and calculus, attrition, and caries. Dental pathology and periodontal status were evaluated with respect to age and location in the dentition. Further techniques such as computed tomography, microhardness testing, histologic sectioning, and scanning electron microscopy were used in selected cases to verify the macroscopic and radiographic diagnoses. Fourteen skulls originating from free-ranging wild Alaskan brown bears (Ursus arctos horribilis) were examined as a control group. For zoo bears over 10 yr old, severe enamel and dentinal attrition has been observed in canine teeth, with exposed pulp and proximal lesions in molar teeth. Deposits of calcified dental calculus were found in various locations and increased with age. A much lower degree of calculus deposition was found in the Alaskan grizzlies, whose average caries frequency was higher but with large individual variation and different locations in canine teeth and occlusal lesions in molar and premolar teeth. Radiographic evaluation of perialveolar osteolytic processes revealed a greater frequency of apical and combined apical-marginal lesions of the alveoli in zoo bears over 10 yr old. Stereotypical behavior like cage chewing is a suspected cause of canine tooth and secondary alveolar lesions, whereas a nutritionally inappropriate diet and inadequate opportunities for tooth-cleaning activities are responsible for the lack of natural cleaning and the extensive calculus formation that results. The methods used in this study are useful in assessing and comparing the dental health status of free-ranging bears, and those living in zoological gardens, by evaluating anesthetized bears or bear skull collections representing both groups.

Obturation of root canals with different sealers using non-instrumentation technology.

AIM: To evaluate and compare the sealing quality of hand- or vacuum-obturated root canals after hand preparation or hydrodynamic cleansing of root canals, respectively. METHODOLOGY: After assessing root curvature, 96 single-rooted deep-frozen teeth were divided into eight comparable groups. The root canals of four groups were instrumented with the balanced force technique. The remaining uninstrumented teeth were connected to a reduced-pressure device (NIT) and the root-canal system perfused with 2.5% NaOCl under alternating pressure fields. This dissolved the pulpal tissues and removed debris from the root-canal system. The canals of the hand-instrumented groups were obturated using the cold lateral condensation method with guttapercha and one of four different sealers (AH26, AH Plus, Apexit and Pulp Canal Sealer EWT). The teeth treated with the alternating pressure device (NIT) were obturated by a vacuum obturation method (NIT) with the same four sealers. The quality of the coronal seal was assessed using a dye penetration method. In order to minimize errors the roots were perfused with water before exposure to the dye, under vacuum. The teeth were then rendered transparent and the depth of penetration of the dye between the wall of the canal and the obturating material was measured with a stereomicroscope. RESULTS: The canals cleaned and filled by NIT showed statistically significantly less dye penetration than those obturated by lateral condensation (P < 0.05). Within the NIT group, Pulp Canal Sealer EWT exhibited significantly more dye penetration than Apexit. Amongst the control lateral condensation groups no significant differences were found between the various sealers. CONCLUSIONS: The present investigation demonstrated the validity of the NIT obturation method in combination with commonly used root-canal sealers.

[Diagnosis and therapy of the rupture of both cruciate ligaments, the medial collateral ligament and abscission of both menisci in a ram. A case report]. / Diagnostik und Therapie der Ruptur beider Kreuzbänder, des medialen Kollateralbandes und Abriss beider Menisken bei einem Schafbock. Ein Fallbericht.

This report describes the case history of a 1.5-year-old ram admitted to the Clinic for Food Animals and Horses, University of Berne, Switzerland, because of an acute severe lameness of the left rear limb. Clinical and radiographic examination revealed disruption of the stifle joint with rupture of both cruciate ligaments, the medial collateral ligament, and disruption of both menisci from their attachments. The ruptured ligaments were replaced by synthetic ligament prostheses. Long-term examination at 12 months after implantation revealed slight instability of the stifle joint, caused by degeneration of the medial meniscus, and signs of arthrosis deformans. The new formed periarticular connective tissue contributed to the stability of the stifle joint, so that a good functional result was achieved. Necropsy findings at 14 months after implantation confirmed that the synthetic ligament prostheses were intact and the medial meniscus was detached from its insertion and incorporated into the joint capsule. At microscopic examination of the synthetic band prosthesis, ingrowth of collagen and fibrous tissue was evident.

[Differential diagnosis of resorptive tooth diseases and caries]. / Differentialdiagnose von Resorptiven Zahnerkrankungen (FORL) und Karies.

Feline Odontoclastic Resorptive Lesions (FORL, previously known as "neck lesions") on cat teeth are compared to caries and differentiated with the use of new methods. Radiological examination reveals typical odontoclastic resorptive processes, which take place at the dental root and at the periodontium. These lesions demonstrate the destruction on the desmodontium and the following ankylosing reaction. The rhodamine B stain which is selective for caries, stains regions which are softened by caries in a dark red way. Fuchsin/Acetic-Light Green stained histological preparations demonstrate the resorptive lacunae, resorptive lagoons and resorptive canals. Giant cells with multiple nuclei and reparative cementum can also be shown with the same stain. Hardness measurements using a Knoop diamond (KHN Knoop hardness number) give information about the degree of hardness of the different tissues. Electron microscopic investigations are performed to show the dentinal tubules and allowing the differentiation between FORL and caries. Since FORL also has been found in wild cats we deduced that alimentation has no effect on the pathogenesis of the disease.

Bone apposition onto oral implants in the sinus area filled with different grafting materials. A histological study in beagle dogs.

The placement of oral implants into jaw bone has a high predictability provided an adequate bone volume surrounding the implant is present to ensure primary stability and resistance to functional loading forces after completion of osseointegration. In the distal area of the maxilla, an adequate bone volume is often lacking because of the proximity of the sinus cavities. The aim of this study was to evaluate histologically the simultaneous placement of endosseous implants into the sinus cavity and the surgical elevation of the sinus floor including filling the cavity with different grafting materials. In 9 sinus areas of 5 beagle dogs, 9 titanium implants (ITI Dental Implant System) were placed, and the void space of the sinus cavity was filled simultaneously with either demineralized freeze-dried human cortical bone (Musculoskeletal Transplant Foundation), resorbable hydroxyapatite (Osteogen) or natural cancelleous bovine bone mineral (Bio-Oss). To study bone formation, fluorochrome markers (tetracycline HCl and calcein green) were used at 2 and 8 weeks. Clinically, all implants healed uneventfully, and 5 months after implant placement the dogs were killed for histologic evaluation. All implants exhibited osseointegration within the pre-existing cortical bone of the sinus floor. The implants surrounded by freeze-dried bone xenografts yielded no formation of new bone, whereas the sites with hydroxyapatite or natural bovine bone mineral demonstrated newly formed bone with direct contact at the implant surface. The average extent of bone to implant contact was 25% (SD = 10.6%) and 27% (SD = 8.8%), respectively in relation to the length of the originally denuded implant surface.(ABSTRACT TRUNCATED AT 250 WORDS)

[Biocem--a new material for retrograde root filling. The 5-year clinical results]. / Biocem--ein neues Material zur retrograden Wurzelfüllung. Fünfjährige klinische Resultate.

This paper describes the application of a new material, Biocem, for retrograde root canal filling. A total of 234 roots in 222 teeth were treated during the period 1987-1992. Biocem consists of two components and once mixed, the autopolymerisation results in a three-dimensional structure. The biomechanical and histologic properties and a clinical longterm follow-up confirm the optimal qualities of this material. It fulfills the requirements in regard to biocompatibility, watertight sealing and application. The material proved superior in comparison to conventional materials and ceramics. The evaluation of the results are most encouraging.

In vivo diagnosis of fissure caries using a new electrical resistance monitor.

The aim of this investigation was to study the accuracy of a newly developed electrical resistance monitor in diagnosing occlusal fissure caries in vivo in teeth without cavitation. The electrical resistance was measured in vivo on human third molars without existing restorations and without any macroscopic carious cavitation. Data from 41 sites on 26 occlusal surfaces were obtained. After measurement, the teeth were extracted, histologically prepared, and serially sectioned perpendicular to the occlusal surface and examined for the presence of caries. Nineteen sites had no caries, 7 had enamel caries, and 15 sites showed dentinal caries, 4 of which deep dentinal caries. For the diagnosis of occlusal caries with the electrical resistance monitor, the specificity was 0.77, the sensitivity 0.93, and the accuracy 0.83. Likelihood ratios for four diagnostic levels (no caries, enamel caries, dentinal caries, and deep dentinal caries) were 0.09, 0, 3.47, and 4.16, respectively. Diagnosis of occlusal caries using conventional bite-wing radiographs showed a specificity of 0.77, a sensitivity of 0.62, and an accuracy of 0.71. The electrical resistance monitor was well suited to detect in vivo occlusal caries under clinically intact fissures. The rather high value (0.23) of false-positive ratings, however, might lead to a substantial number of sound teeth being restored unnecessarily. Substantial improvement of occlusal, caries diagnosis may be achieved by combining this method with others.

Histologic probe penetration in healthy and inflamed peri-implant tissues.

Periodontal probing is commonly used for assessing both the status of gingival health and the connective tissue attachment level around teeth. The role of probing around endosseous implants still remains unclear. The purpose of this study was to determine the histological level of probe penetration in healthy and inflamed mucosal tissues around implants. Five beagle dogs were used and a total of 30 one-stage, Titanium Plasma Spary (TPS)-coated implants of the ITI type were placed in the mandibles. After the healing period with meticulous oral hygiene, the dogs were divided into 3 groups: 1) clinical healthy mucosal tissues; 2) experimental mucositis (3 dogs); and 3) experimental ligature-induced peri-implantitis (2 dogs). Four months after implant placement, respectively 6 months in the third group, 60 probes were placed with a standardized force of 0.2 N and fixed at the mesial and distal aspects of the implants. Probing depth, clinical attachment level (CAL), Plaque Index (PlI) and Gingival Index (GI) were assessed throughout the study. Tissue sections were obtained for histometrical analysis. In the healthy group, the mean PII was 0.47, the GI 0.06 and the clinical probing depth (CPD) 2.12 mm. In the mucositis group the PlI was 1.61, the GI 1.61 and the CPD 1.87 mm. In the peri-implantitis group the PlI was 1.96, the GI 2.05 and the CPD 3.73 mm. The histologic results show that the probes were able to identify the connective tissue adhesion level in the healthy group with a mean error of -0.05 mm (mean histologic probing depth (HPD): 1.75 mm) and, in the mucositis group, with -0.02 mm (mean HPD: 1.62 mm). Probe penetration increased with the degree of inflammation and in the peri-implantitis group the probe exceeded the connective tissue level by a mean 0.52 mm (mean HPD: 3.8 mm). Therefore, probing around implants represents a good technique for assessing the status of peri-implant mucosal health or disease.