[Guideline Antibiotics in oral surgery]. / Leitlinie Antibiotika in der Oralchirurgie.

Antibiotics can be used in oral surgery. The effective benefits are offset by the dangers of resistance and sensitization, which requires a strict indication. There are controversial views regarding indication, dosage and, above all, duration and timing of antibiotic medication in oral surgery.

Periodontal ligament on pulp-free root slices ­ an in vitro model for early tooth (re)integration. An exploratory study

Reintegration of freshly extracted healthy teeth is very successful, most likely due to the regenerative capacity of their roots' residual periodontal ligament (PDL). We hypothesised that in vitro cultures of the consecutive slices of a sectioned root will represent the entity of PDL cell types engaged in tooth-sided reintegration. For confirmation, apex and pulp from human premolars were removed and roots cut into 6 to 9 about 1 mm thick slices. These were immobilised to separate wells and cultured for 20 days, under daily inspection for the initiation of cell outgrowth (ICO). ICO and the distribution of vital slices along, the cell growth around as well as the expansion of outgrown cells off the root axes after 20 days were displayed for each tooth as 3D-like profiles. Of the 81 slices from 11 teeth, 55 showed ICO; 64% within one week and 96% within two weeks. Such dynamics compare to the early (day 2­5) and the intermediate (day 9­14) integration phase reported for PDL cells in vivo. Experimental phase contrast images of a single slice showed at ICO few fibroblast- and stem/progenitor- like cells. Four and five days later at the same site cells had grown in number and changed in shape and space over time. This exploratory study indicates that in root slice cultures PDL cells behave similarly to those during reintegration in vivo. It favours our hypothesis, which is now to be adequately verified. Eventually, the model may facilitate the identification of outgrowing cells and cellular changes over time, as triggered by tissue rupture. It may further allow for emulating cellular interactions between the root surface and alveolar bone or engineered constructs, natural or engineered scaffolds, or other tissue, in an in vivo-like situation.

Diagnostics of tongue coating using autofluorescence.

In the present study, the VELscope® autofluorescence device was used in addition to the Winkel Tongue Coating Index (WTCI) to evaluate tongue coating; a corresponding index was developed for evaluation with VELscope®. The distinct orange fluorescence of the tongue dorsum caused by autofluorescent bacterially colonized areas motivates halitosis patients to optimize tongue hygiene. The tongue dorsum of 100 volunteers (35 males, 65 females, average age 51 years) was photographed with and without the autofluorescence device. On the computer, all tongue photographs were divided into sextants. These pictures were evaluated randomly by six investigators (5 inexperienced and the experienced head of the halitosis consultation hour). Both methods localized the highest coating density in the mid posterior area of the tongue. Significant differences were found between the WTCI and the VELscope® Index (p < 0.001). While WTCI was more sensitive in discriminating between absence and presence of sparse coating, VELscope® imaging was relatively insensitive to sparse coating, but better detected dense coating than did WTCI. For both methods, inexperienced and experienced examiners achieved comparable results (kappa coefficient without VELscope® 0.654, with VELscope® 0.672). The VELscope® device can complement tongue coating diagnosis, but it cannot replace the Winkel Tongue Coating Index.