Defining the neuroanatomic basis of motor coordination in children and its relationship with symptoms of attention-deficit/hyperactivity disorder

BACKGROUND

When children have marked problems with motor coordination, they often have problems with attention and impulse control. Here, we map the neuroanatomic substrate of motor coordination in childhood and ask whether this substrate differs in the presence of concurrent symptoms of attention-deficit/hyperactivity disorder (ADHD).

METHOD

Participants were 226 children. All completed Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)-based assessment of ADHD symptoms and standardized tests of motor coordination skills assessing aiming/catching, manual dexterity and balance. Symptoms of developmental coordination disorder (DCD) were determined using parental questionnaires. Using 3 Tesla magnetic resonance data, four latent neuroanatomic variables (for the cerebral cortex, cerebellum, basal ganglia and thalamus) were extracted and mapped onto each motor coordination skill using partial least squares pathway modeling.

RESULTS

The motor coordination skill of aiming/catching was significantly linked to latent variables for both the cerebral cortex (t = 4.31, p < 0.0001) and the cerebellum (t = 2.31, p = 0.02). This effect was driven by the premotor/motor cortical regions and the superior cerebellar lobules. These links were not moderated by the severity of symptoms of inattention, hyperactivity and impulsivity. In categorical analyses, the DCD group showed atypical reduction in the volumes of these regions. However, the group with DCD alone did not differ significantly from those with DCD and co-morbid ADHD.

CONCLUSIONS

The superior cerebellar lobules and the premotor/motor cortex emerged as pivotal neural substrates of motor coordination in children. The dimensions of these motor coordination regions did not differ significantly between those who had DCD, with or without co-morbid ADHD.

[On the indications for and morbidity of segmental resection of the mandible for squamous cell carcinoma in the lower oral cavity]

BACKGROUND

Segmental resection of the mandibula in oral cancer surgery leads to both functional and aesthetic problems. The decision to preserve or resect the mandible depends on the vicinity of the lesion to the bone. Consequently, based on the rules of safety margins to all planes that are recommended for soft tissues, each lesion that is closer than 10 mm to the mandible needs resection of the bone.

PATIENTS AND METHODS

To establish data-based treatment modalities, a retrospective study was initiated and the results from all preoperative staging investigations of 152 patients with intraoral squamous cell carcinoma who underwent continuity or marginal resection of the mandible were evaluated. The histological outcome of the resected bone was compared to the staging results. Functional rehabilitation and long-term follow-up including survival rates were evaluated. The study reports on typical complications following segmental resection such as fracture of the reconstruction plate and demonstrates experiences with secondary microsurgical reconstructive surgery.

RESULTS

Mainly in cases of stage T1 and T2 carcinomas which are closer than 10 mm to the bone and clinically do not show any infiltration to the mandible, a marginal resection seems to be adequate. The decision about the extension of mandibular resection can be based on intraoperative cross sectional investigation of the periosteum. The survival rate of patients with intraoral carcinomas close to the mandible who underwent marginal mandibulectomy seems to be the same as in cases of continuity resection. A more conservative management of mandibular resection seems to be adequate and a data-based concept to standardize therapy of mandibular resection is presented.

Kombination der Sinusliftoperation mit der lateralen Kieferkammaugmentation

PURPOSE

This paper describes a surgical and prosthetic procedure for treating the extremely atrophic maxilla. It explains a two-staged surgical technique, donor and recipient site morbidity, implant survival, and the implant-retained prosthetic rehabilitation of the patients.

PATIENTS AND METHODS

A total of 57 consecutive patients were treated with a sinus lifting procedure and a simultaneous lateral augmentation using autogenous corticocancellous block and particulate bone grafts from the iliac crest. After a 6-month bone healing period, a total of 284 endosteal Titanium screw implants were inserted. Following a 3-month osseointegration period, the implants were exposed and loaded with either fixed or removable prostheses.

RESULTS

In three cases a partial bone graft loss was observed; however, enosseous implantation was possible as planned. During the observation period none of the 284 implants was lost; 3 implants exhibited treatable peri-implant infection. Complications at the donor and recipient sites were minimal and did not negatively influence the overall clinical result of the treatment.

CONCLUSION

The combination of sinus lift procedure and lateral augmentation for the treatment of the extremely atrophied maxilla proved to be a safe method that produces good and reliable clinical results.

Der transparotideale Zugang zur operativen Versorgung von Collumfrakturen

AIM

Different surgical approaches for the open treatment of mandibular condylar fractures are described in the literature. We evaluated the morbidity of the transparotidean approach in a prospective study over 5 1/2 years.

PATIENTS AND METHODS

A total of 48 patients with 52 condylar neck fractures class II and IV according to the Spiessl and Schroll classification were treated by a transparotidean approach. Rigid internal fixation was performed by means of miniplate fixation. After surgery, no mandibulomaxillary fixation was performed. The occurrence of surgical and functional complications was documented both during hospitalization and 1, 3, 6 and >9 months after surgery.

RESULTS

In none of our patients were major problems in wound healing such as infection of the fracture site observed. At the beginning of the study, in four cases a fistula of the parotid gland was seen within the initial days after surgery; after careful wound closure of the parotid capsula in the following operations, no further complications involving fistulas were observed. Signs of temporary palsy of the facial nerve caused by the hooks occurred in ten (19.6%) of all patients but was completely reversible within the first 6 months after the procedure. One patient suffered temporarily from a minimal malocclusion and two patients from symptoms of the temporomandibular joint 6 months postoperatively. In three patients we observed miniplate fractures without consecutive dysfunction of the TMJ or malocclusion.

CONCLUSION

Open reduction and rigid internal fixation of condylar neck fractures by transparotidean approach is a recommendable procedure in class II and IV fractures. With the advantages of minimal tissue alteration and rare complications on the one hand and sufficient exposure of the fracture site on the other hand, this technique has been established as a standard procedure in treating condylar neck fractures by open reduction.

Basic surgical principles with ITI implants

The basic surgical principles governing the placement of ITI implants are based on research-oriented developments in harmony with evidence-based and outcome-oriented clinical procedures. In the past 15 years, the range of implant indications has been significantly widened, and partially edentulous patients clearly represent the majority of patients seeking treatment with dental implants today. An important aspect of the successful rehabilitation of patients with ITI implants is the careful selection of implant candidates with respect to systemic and local risk factors. These factors are presented based on current knowledge. Today, solid-screw implants in various screw dimensions and neck configurations comprise the ITI Dental Implant System. These different implant types are necessary to handle the full range of implant indications, in particular in partially edentulous patients. The main clinical factors are presented for the selection of the appropriate implant type, length and diameter. These implants are utilized both in a non-submerged and in a submerged approach. The main goal of surgical therapy is low trauma and the least demanding surgical procedure for patient and clinician to optimize the cost-effectiveness of implant therapy. Hence, a non-submerged approach is preferred in all sites without esthetic priority, such as in fully edentulous patients or in posterior sites of partially edentulous patients. These indications clearly represent the majority of implant patients. In esthetic sites, a submerged approach is utilized to satisfy the specific esthetic demands. The possibility to successfully utilize short implants (6 and 8 mm) and a reduced healing period of 3 months are further advantages of ITI implants due to favorable properties of the rough TPS surface. With the introduction of the microrough SLA surface, a reduction of the healing period to 6 weeks facilitates further progress towards simplification of implant therapy. In summary, the ITI Dental Implant System represents a scientifically well-documented, complete implant system for the treatment of fully and partially edentulous patients, offering straightforward surgical concepts based on predictable treatment outcome and excellent cost-effectiveness.

Treatment of fully edentulous patients with ITI implants

The use of ITI implants for rehabilitation of the edentulous patient has shown predictable results not only in the standard sites but also in cases of advanced alveolar ridge atrophy. Preoperative analysis, including clinical and radiological evaluation, implant selection, and determination of implant number and distribution in the edentulous maxilla and mandible, is described in this article. The surgical procedures used in standard sites are presented, the benefits of a nonsubmerged surgical approach in these cases are emphasized, and a protocol for postoperative management is recommended. Augmentation procedures in advanced osseointegration surgery call for submerged ITI implants when a simultaneous approach is chosen. Several types of advanced implant surgery that can be used are described, including membrane technique, sinus lift procedures, vertical ridge augmentation with iliac bone grafts, and correction of sagittal jaw relationship.

[Mid-face distraction after LeFort III osteotomy in craniofacial dysmorphism]

BACKGROUND

The success of LeFort III-osteotomy with concurrent advancement of the midface in cases of severe, midfacial hypoplasia is limited by the soft covering tissue of the facial skeleton. There appear to be significant advantages in using distraction osteogenesis of the midface after surgery.

CASE REPORT

We discuss the use of an extraoral distraction device after the osteotomy of a 10-year-old girl with Crouzon's disease. and the use of an internal device for a 6-year-old boy with severe midface hypoplasia following Apert's syndrome.

RESULTS

In both patients a significant improvement of function, as well as harmonisation of the facial proportions, could be observed and the preoperatively planned distances of midface advancement of 18 and 15 mm respectively could be achieved.

DISCUSSION

Distraction osteogenesis is an established procedure for the treatment of mandibular hypoplasia but few reports dealing with complex midface distraction are available outside of the specialist English language literature. We report on both external and internal distraction techniques with which good functional and aesthetic results were achieved.

[Resorbable osteosynthesis material in craniosynostosis]

BACKGROUND

The results of using resorbable plates and screws (82% polylactic acid and 18% polyglycolic acid) in craniofacial surgery for the correction of craniosynostosis after more than 4 years of experience are presented. Special attention is focussed on the degree of stability and the clinical tissue response to the material employed to answer the question of whether the material is an adequate alternative to titanium.

METHODS

Thirty patients who had been treated with this method for craniosynostoses were examined at regular intervals regarding the shape and stability of the forehead region, visibility and palpability of the plates, and tissue reactions.

RESULTS

The technical handling of the osteosynthesis material proved to be simple and reliable. In one case the bone was not strong enough for the screw pitch. After an observation period of a maximum of 4 years and 1 month, the fixations were stable with no signs of adverse reactions.

DISCUSSION

If the long-term results remain favorable, we consider the use of resorbable material a promising method for the stabilization of segments in craniofacial surgery in children.

[Peri-osseous intracranial translocation of titanium osteosynthesis plates and screws after fronto-orbital advancement]

BACKGROUND

Perossoeus intracranial translocation or passive intracranial transmission of titanium osteosynthesis plates and screws in the growing skull following surgical craniosynostosis corrections, also referred to as the PIT effect, has been described in the literature since 1995. It is a phenomenon which has not received due attention until recently and is explained by appositional and resorptional remodeling processes in the growing skull.

CASE REPORT AND DISCUSSION

An impressive case of the PIT effect with a total intracranial dislocation of titanium plates and screws is used to demonstrate the problems associated with this phenomenon and to discuss the few clinical case reports in the English-language literature. The obvious advantages of a resorbable material are pointed out; however, it is still uncertain as to whether the resorption process is fast enough to avoid the PIT effect if used clinically.

[Hemostatic wound management in marcumar patients. Collagen fleece vs. tranexamic acid]

A total of 124 patients on oral anticoagulation therapy with coumarin were treated by orosurgical procedures and entered into a study to determine the hemostatic efficiency of different methods. The therapeutic anticoagulation level was determined in accordance with the recommendations of the American Heart Association (low risk: 2.0 < INR < 3.0; high risk: 2.5 < INR < 3.5) and maintained during treatment. In one group, the alveoli were treated with collagen, in a second group a mouthrinse regime with tranexamic acid was implemented. Twenty-three patients had to be excluded because anticoagulation levels differed from the recommended values. The group treated with collagen included 31 patients, the group with tranexamic acid mouthwashes, 32 patients. A third group was analyzed in which a controlled change in the anticoagulation level had been performed and all treated alveoli had been covered by mucosal flaps (n = 38); they were compared to the other two groups. The surgical proceedings were outlined precisely. Patients treated with collagen had a bleeding rate of 19%, patients with tranexamic acid mouthwash 6%, and those treated with mucosal flaps 40%. The data were not suited for statistical evaluation, they were objected to a descriptive analysis: the confidence intervals were determined by tables for binomial distributions. These did confirm the difference in the frequency of bleeding for the tranexamic acid and mucosal flap groups.

Oral findings in three different groups of immunocompromised patients

The objective of this study was to determine the frequency of oral, dental and periodontal findings in three different groups of immunocompromised patients and in a healthy control group, to evaluate whether there is a correlation between manifestations of disease and immunologic parameters. The survey included 46 patients with a diagnosis of systemic lupus erythematosus, 48 heart transplant recipients, and 53 adult patients suffering from acute leukemias. Fifty matched healthy subjects were used as a control group. Each patient had to answer questions on medical and dental health and underwent a thorough oral, dental and serological investigation. Oral mucosal lesions were found in nearly half of all immunocompromised patients (49.6%), but in only 26% of control patients. No significant associations were found between different types of oral lesions and the underlying cause of immunosuppression. Leukemia patients showed age-unrelated higher scores in periodontal indices (P<0.05). Laboratory parameters failed to be significant in the assessment of oral health.

Heart transplants--assessment of dental procedures

The object of this study was to evaluate the effects of dental foci on survival rates and rejection episodes in heart transplant recipients. Therefore, in a retrospective longitudinal study we studied 74 heart transplant recipients at the Department of Maxillofacial Surgery and Department of Thoracic and Cardiovascular Surgery, University of Münster. Study patients were divided into groups: those in which dental foci had been verified (n = 31) and those without dental foci (n = 43). Statistical analysis was performed using the chi-square test, Kaplan-Meier life table analysis, and the log-rank test. Before heart transplantation, patients were screened clinically and radiographically to determine the extent of dental foci. Postoperatively, patients were evaluated dentally and medically to identify the impact of dental foci on the incidence of systemic and oral infections, frequency and severity of rejection episodes, mortality, and complications arising during dental treatment. By comparing the mortality, infection and rejection rates in the various groups no statistically significant differences (P > 0.05) were found between patients. Despite immunosuppression, extended inflammatory processes such as abscess formation or viral stomatitis were not found in the oral cavity. We therefore suggest that patients suffering from the symptoms of severe heart failure need not be subjected to rigorous preoperative dental treatment.

[Preliminary results of the use of resorbable plates and screws in craniofacial surgery]

In ten patients with craniosynostoses resorbable plates and screws (Lactosorb) consisting of poly-L-lactic acid (82%) and poly-glycolic acid (18%) were used to stabilize the segments after frontoorbital advancement. As our experience increased, an exact adaptation of the plates and simple handling proved to be possible. The plates were stable enough to retain a favorable functional and aesthetic result after redraping the soft tissue envelope. In one patient with Chotzen's syndrome the intended use of the resorbable material was abandoned: the thin osseous structures did not offer enough primary stability to the high pitch of the screws. During an observation period of up to 21 months no infection, exposure, instability or dislocation was observed. The clinical use of the resorbable material in frontoorbital advancement proved to be a stable method of segment fixation if the bone was of sufficient thickness. These promising preliminary results will have to observed in a larger group and over a longer period of time.

Use of a mandibular fracture score to predict the development of complications

PURPOSE

Mandibular fractures are common facial injuries. Classifications are diverse and sometimes correlated with specific treatment modalities. Osteosynthesis using plate and screws is the standard method of fracture treatment. To evaluate the outcome of such fracture management in our clinic, we developed a numeric scoring system for mandibular fractures and investigated the relationship between the scoring of the fracture being treated and the incidence of complications after surgical treatment.

PATIENTS AND METHODS

Seventy-six adult patients treated over a 2-year period were evaluated, and the fractures were classified using the mandibular trauma score. This score was based on clinical and radiologic evaluation of each fracture line and ranks from 0 to 15 points. Osteosynthesis was performed using the AO plate systems. Patients were followed-up postoperatively for the presence of complications.

RESULTS

During the 2-year period, 76 patients with 134 fractures underwent plate osteosynthesis. Fracture scoring indicated a homogeneous distribution between uncomplicated and severe fractures. The incidence of complications increased with the fracture severity, assessed by the fracture score index. Severe fractures showed fewer complications when treated with a rigid plate system, whereas low-score fractures showed better results when treated with less rigid systems.

CONCLUSIONS

The numeric scoring system for mandibular fractures allows an objective and standardized assessment of the degree of severity of a fracture and may facilitate decisions about the use of specific treatment modalities.

[Surgical correction of the sagittal shift of the jaws in severe alveolar atrophy]

A method for treatment of sagittal discrepancy in edentulous patients is described, which includes simultaneous maxillary repositioning by means of a Le Fort I osteotomy and placement of endosseous implants. The technique of mandibular setback using the sagittal osteotomy of the mandible according to Obwegeser-Dal Pont's method and placement of implants in patients with extreme class III relationships is also presented. We outline the importance of thorough diagnosis, model surgery and its transfer at the time of the operation. The study of 12 consecutively treated patients with a follow up of 4.2 years showed functionally and esthetically good results after combined surgical and implantological treatment.

[Oral manifestations in patients with systemic lupus erythematosus]

Forty-six patients with systemic lupus erythematosus underwent thorough dental examination to determine the frequency and severity of oral lesions and periodontal diseases. According to clinical criteria, disease was classified as severe (n = 26) or less severe (n = 20). The overall rate of mucosal involvement in the studied patients was 48%-from 54% in patients with severe disease, 40% in those with less severe disease. Patients with severe disease were found to have a higher rate of tooth loss and an increased rate of gingival inflammation. The severity of periodontal lesions correlated with alterations in the immunoglobulin pattern, particularly with an increase in gamma-immunoglobulins. Thus it is suspected that complex immunodysregulation in combination with immunosuppressive therapy is responsible for the high rate of oral and periodontal lesions in patients with systemic lupus erythematosus.

[Oral manifestations of acute leukemia]

It is well known that non-specific mucosal alterations can occur during diseases of the leukopoetic system. In most cases they are an early sign and therefore provide the opportunity for timely diagnosis of the disease. In this clinical study type and frequency of oral lesions, gingival and periodontal indices, and hematologic status were examined at the time of diagnosis of the different types of acute leukemia. The results showed a significant difference in the frequency of oral lesions between acute myelogenous and acute lymphoblastic forms, irrespective of age and sex of the patient. There was no correlation between type and frequency of lesions and hematologic status.

Health human periodontal versus peri-implant gingival tissues: an immunohistochemical differentiation of the extracellular matrix

Healthy human periodontal and peri-implant (ITI Bonefit) keratinized gingival tissues were studied immunohistochemically to evaluate the possible presence of structural differences in the extracellular matrix protein localization. Collagen types I, III, IV, and VII and fibronectin showed similar distribution in these tissues. Compared to the periodontal tissues, collagen type V was localized in higher amounts in the lamina propria of the peri-implant gingival tissues. Collagen type VI stained the periodontal tissues as a delicate microfibrillar network contrasting to the not well-stained peri-implant gingival tissues. The data show that structural differences between these tissues are present. The structural differences may be responsible for the defense of peri-implant keratinized gingival connective tissues to bacterial penetration, because of the high amount of the collagen type V component, which is responsible for the higher collagenase stability.

Fabrication of all-ceramic In-Ceram implant-supported bridges: a case report

Ceramic restorative materials offer certain advantages over metal-acrylic and metal-ceramic restorations, including low plaque accumulation, corrosion resistance, nonallergenic properties, and excellent aesthetic results. A new ceramic material with a high aluminum content has been recently developed. It addresses the problem of some other materials which absorbed saliva in the oral environment and caused microcracks, rendering them unsuitable for multi-unit suprastructures. The learning objective of this case report is to describe the clinical and laboratory procedures for fabrication of the all-ceramic implant-supported suprastructures for an edentulous patient after orthognathic surgery and the placement of associated endosseous oral implants.

Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region

The deposition of titanium in regional lymph nodes was studied after insertion of endosseous, plasma-spray-coated titanium screw implants in a total of 19 beagle dogs. Five additional animals with no implants served as the control group. After killing the animals 9 months postoperatively, the regional lymph nodes were carefully excised, and samples were prepared for histologic examination. Other samples were used to identify foreign particles by energy-dispersive x-ray analysis and for measurement of the titanium concentration in the tissue by flameless atomic absorption spectroscopy. Very fine foreign-body particles could be seen in the histologic sections, and they were identified as titanium by energy-dispersive x-ray analysis. The atomic absorption analysis for titanium revealed a significantly higher concentration in the group with implants. The presence of very fine, poorly attached particles on the plasma-sprayed titanium surface suggests that these particles may be mechanically dislodged from the surface on insertion of the implants. This suggests that the fine particles may be transported by phagocytes to the regional lymph nodes, where they could be found without any signs of inflammation or foreign-body reaction.

ITI implants in combination with bone grafts: design and biomechanical aspects

In this article we describe the implantation of ITI implants in combination with bone grafts. Two different cases were considered: the augmentation of an atrophic maxilla or mandible where the transplant was fixed by means of ITI implants and the implantation into free transplants fixed by means of the THORP reconstruction plate system. These indications require 2-stage procedures with submerged implants and transplants during the healing period. For this new applications, standard ITI implants were combined with specially developed new transgingival units of high manufacturing precision. The new design resulted in a maximum tightening moment of 4.0 N.m versus 1.25 N.m achievable with a conventional 2-mm screw. Dynamic testing showed that, for the range of tightening moments of 0.25 N.m up to 1.0 N.m, the loosening moment after 2,000,000 cycles remained approximately 10% above the tightening moment. For the clinical application a tightening moment of 0.35-0.5 N.m is recommended. The special design and the high precision of the extension parts results in a tight adaptation between the primary implant and the extension parts, which may be important for microbiological reasons.

Strip ostectomy and radical ostectomy in the treatment of craniosynostosis. An experimental animal study

In an experimental animal study using rabbits, growth phenomena were simulated which are comparable to craniosynostosis in humans. The radiological and histological findings after surgical management of these artificial craniosynostosis by means of strip ostectomy or radical ostectomy were compared with the findings obtained in control animals. Following strip ostectomy, bone defects were rapidly filled by the formation of suture-like structures. After radical ostectomy, structures consisting of connective tissue dispersed among islands of ossification were preserved over a considerable period of time, making it possible for the calvarium to adapt to the fast-growing brain. In contrast to strip ostectomy, after radical ostectomy growth of both the neurocranium and the viscerocranium, as well as the total sagittal growth of the skull, were almost identical to the corresponding growth in the control animals.

A tomographic technique for the depiction of atrophied alveolar ridges prior to endosseous implant placement

Radiographic examination is of particular importance prior to the placement of dental implants, especially when the alveolar ridge is severely atrophied. Accurate assessment of the amount of residual bone can be improved with tomography. A method is described which utilizes templates and marking aids to facilitate the correct positioning of the jaws so as to obtain a true cross-section of the alveolar ridge at the intended implant sites. The same template can be used to determine the location and angulation of the implant at surgery.

Antimicrobial effects of the tetrachlorodecaoxygen-anion complex on oropharyngeal bacterial flora: an in vitro study

The susceptibility of 276 different strains of bacteria derived from the oropharyngeal flora to the tetrachlorodecaoxygen-anion complex (TCDO) was tested using the agar dilution method. The results showed that at therapeutic concentrations of the drug the growth of all the strains tested was inhibited, with the exception of Candida albicans. The pathogenic anaerobes proved to be particularly sensitive to TCDO.

Penicillin concentration in the compact bone of the mandible

During surgical removal of impacted third molars, the concentration of Penicillin G was determined in the compact bone of the mandible. Fifteen patients received 5 million IU and 15 received 10 million IU of Penicillin G intravenously as a single dose before surgery began. In both groups concentrations of penicillin with a bactericidal effect on most pathogenically relevant oral bacteria were detected during osteotomy. Taking into account the considerable interindividual variation, the one-shot application of 10 million IU of Penicillin G was more effective in certain cases than the 5 million IU dose. The factors influencing the decision on the high single-dose application include expected length of operation, body weight, kidney function, and infusion period. Assuming that in intraoral osteotomies the bone becomes contaminated with bacteria that are highly sensitive to penicillins, the results indicate that preoperative infusion of Penicillin G could be an effective method of preventing wound infection.

[Carcinoma in a 40-year chronic oro-antral communication]

A squamous cell carcinoma developed in a 66 year old patient in the region of a traumatically caused oro-antral fistula that has persisted for 40 years. The clinical course and histological findings are presented. Based on the few case reports in the literature the occurrence of malignancies in chronic traumatic fistulae is discussed. Reference is also made to causal relationships between such a fistula and malignancy under the aspect of forensic medical consultations.

[Rehabilitation of an edentulous patient with implant supported all-porcelain bridges after orthognathic surgery]

This case report presents a 43-year-old woman who was not happy with her complete dentures both from the functional and the esthetic point of view. The combined therapy of orthognathic surgery, insertion of endosteal oral implants and the loading with all-porcelain cantilevered bridges made out of In-Ceram is reported.

[Control of the re-epithelialization of skin defects and burns]

In an experimental study an attempt was made to compare the effect of the tetrachlorodekaoxygen anion complex (TCDO) with an aqueous KCl/CaCl2 solution of a defined molar concentration in hydrogel on the basis of skin defects, irradiated skin defects, and necrectomized burns of the skin of the back of naked euthymic guinea pigs. The wound healing of the irradiated skin defects and the necrectomized burns was found to be generally delayed. The use of the Kcl/CaCl2 solution in hydrogel, however, brought about a faster repair of the defects than the application of TCDO.

[Basal cell nevus syndrome in roentgen diagnosis of the skull]

Besides uni- and multilocular jaw cysts the Gorlin-Goltz-syndrome shows other characteristic radiographic findings which help to ensure diagnosis. These are particularly calcification of the falx cerebri and a so called "bridging" between processus clinoideus anterior und posterior of the sella turcica. The importance of early diagnosis is stressed.