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Treatment Concept (treatment + concept)
Selected AbstractsRationale for esthetic tissue preservation of a fresh extraction socket by an implant treatment concept simulating a tooth replantationDENTAL TRAUMATOLOGY, Issue 1 2010Georgia Trimpou A soft-tissue recession must be avoided, whether it is due to a compression of the peri-implant soft-tissue caused by an over-dimensioned restoration in the cervical collar of the provisional crown or to a too small dimensioned sulcus former. A simulation of the exact dimension of the lost tooth , especially on the cervical part of the new provisional restoration , is expected to preserve all relevant information and allows the design of a naturally looking emergence profile. Based on theoretical considerations and a case report, the authors intend to demonstrate that a near-naturally dimensioned sealing of the dento-gingival soft-tissue collar may initiate a tissue-maintaining healing process, similar to a tooth replantation. The natural dental crown, connected to an implant instead of the root, is applied for a tight sealing of the wound. If due to traumatic impact the tooth is no longer available, a naturally dimensioned crown restoration will serve as an alternative wound sealant. [source] Outcome of sinonasal melanoma: Clinical experience and review of the literature,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2010Thomas N. Roth MD Abstract Background. Primary sinonasal malignant melanoma (SNMM) is a rare clinical entity. There is neither a classification nor a staging system nor an evidence-based treatment concept established. Our objective was to find potential risk factors predicting the outcome. Methods. Twenty-five patients with histologically confirmed SNMM were consecutively included and retrospectively analyzed. Staging methods were nasal endoscopy, CT, MRI, and positron emission tomography (PET) scan. Patients were selected for a curative or palliative concept. All patients had postoperative follow-up with control-MRI at 3 and 6 months. Restaging was performed when local recurrence occurred. Results. Nineteen patients underwent primary surgery with curative intention; in 16 cases with tumor free margins. Thirteen patients (68%) had transnasal endoscopic surgery, 4 lateral rhinotomy, and 2 transfacial approach with orbital exenteration. Six patients (32%) had palliative therapy and 7 patients (37%) had adjuvant radiotherapy. Despite radical operations, 6 patients (37%) showed local recurrence and 8 patients (50%) developed distant metastasis. In 2 patients with incomplete surgery, regional metastasis was noted. The median disease-free interval was 18 months, and the median overall survival rate was 23 months. Conclusion. SNMMs of the ethmoid and maxillary sinuses have a worse prognosis than other localizations in the nasal cavity; infiltration into the skull base, orbit, or facial soft tissue correlates with a very poor outcome corresponding to the palliative situations. Furthermore, local recurrence insinuates aggressive disease with short survival rate. A main difference from its cutaneous counterpart seems to be a primary tendency to hematogenic spread. Further research is needed to confirm these findings. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source] The von Willebrand disease prophylaxis network: exploring a treatment conceptJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 11 2006E. BERNTORP [source] State of the art and future directions of scaffold-based bone engineering from a biomaterials perspectiveJOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 4 2007Dietmar Werner Hutmacher Abstract Scaffold-based bone tissue engineering aims to repair/regenerate bone defects. Such a treatment concept involves seeding autologous osteogenic cells throughout a biodegradable scaffold to create a scaffold,cell hybrid that may be called a tissue-engineered construct (TEC). A variety of materials and scaffolding fabrication techniques for bone tissue engineering have been investigated over the past two decades. This review aims to discuss the advances in bone engineering from a scaffold material point of view. In the first part the reader is introduced to the basic principles of bone engineering. The important properties of the biomaterials and the scaffold design in the making of tissue engineered bone constructs are discussed in detail, with special emphasis placed on the new material developments, namely composites made of synthetic polymers and calcium phosphates. Advantages and limitations of these materials are analysed along with various architectural parameters of scaffolds important for bone tissue engineering, e.g. porosity, pore size, interconnectivity and pore-wall microstructures. Copyright © 2007 John Wiley & Sons, Ltd. [source] Successful outcome of splinted implants supporting a ,planned' maxillary overdenture: a retrospective evaluation and comparison with fixed full dental prosthesesCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2009A. Sanna Abstract Objective: Whereas an overdenture concept is generally accepted for the mandible, the outcome of this therapy for the maxilla remains less documented. This retrospective analysis evaluated the peri-implant parameters of implants supporting a ,planned' overdenture in the maxilla, and compared these data with those of an age-matched control group, with a fixed full dental prosthesis. Material and methods: All patients with an implant-supported overdenture in the maxilla from the Leuven University Hospital (at least 12 months in function) were recalled for a thorough examination. Forty-four patients (162 implants, Brånemark type) could be enrolled. Results: The mean loading time was 9 years (range: >1 to >20 years). The cumulative survival rate after 10 years of function was 99.3% if four to six interconnected implants supported the overdenture, but only 85.7% in case two non-connected implants were used as support. The marginal bone level in the former group remained stable, with changes comparable with those observed for implants supporting fixed full dental prostheses. Conclusions: These results fully support the overdenture treatment concept for the maxilla, at least when ,4 splinted implants are used. [source] Context-Oriented Model Development in Psychotherapy Planning (,COMEPP'): a useful adjunct to diagnosis and therapy of severe personality disordersACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2004M. Fischer-Kern Objective:, Pathogenous interpersonal (e.g. interfamilial) relationships and reference styles can compromise treatment efforts in severely disturbed (i.e. psychotic or borderline) patients. The integration of family- and individual-centred starting points may be useful in establishing interdisciplinary treatment concepts in these patients. Context-Oriented Model Development in Psychotherapy Planning (COMEPP) represents a diagnostic and therapy planning process, integrating both systemic and psychoanalytic conceptualizations. Method:, COMEPP is exemplified by the case of a young man with psychotic personality disorder who had previously been unresponsive to pharmacological and psychological treatment. Results:, After psycho-dynamical conflicts (i.e. primitive projective processes from the patient's mother to her son) had been elucidated during the COMEPP process, a sufficient treatment setting could be established. Conclusion:, COMEPP provides a psychotherapeutical approach to treatment planning on case-specific premises and may serve as an adjunct to concomitant pharmacological and psychological treatment strategies in so-called ,therapy refractory' patients. [source] New developments in our understanding of acne pathogenesis and treatmentEXPERIMENTAL DERMATOLOGY, Issue 10 2009Ichiro Kurokawa Abstract:, Interest in sebaceous gland physiology and its diseases is rapidly increasing. We provide a summarized update of the current knowledge of the pathobiology of acne vulgaris and new treatment concepts that have emerged in the last 3 years (2005,2008). We have tried to answer questions arising from the exploration of sebaceous gland biology, hormonal factors, hyperkeratinization, role of bacteria, sebum, nutrition, cytokines and toll-like receptors (TLRs). Sebaceous glands play an important role as active participants in the innate immunity of the skin. They produce neuropeptides, excrete antimicrobial peptides and exhibit characteristics of stem cells. Androgens affect sebocytes and infundibular keratinocytes in a complex manner influencing cellular differentiation, proliferation, lipogenesis and comedogenesis. Retention hyperkeratosis in closed comedones and inflammatory papules is attributable to a disorder of terminal keratinocyte differentiation. Propionibacterium acnes, by acting on TLR-2, may stimulate the secretion of cytokines, such as interleukin (IL)-6 and IL-8 by follicular keratinocytes and IL-8 and -12 in macrophages, giving rise to inflammation. Certain P. acnes species may induce an immunological reaction by stimulating the production of sebocyte and keratinocyte antimicrobial peptides, which play an important role in the innate immunity of the follicle. Qualitative changes of sebum lipids induce alteration of keratinocyte differentiation and induce IL-1 secretion, contributing to the development of follicular hyperkeratosis. High glycemic load food and milk may induce increased tissue levels of 5,-dihydrotestosterone. These new aspects of acne pathogenesis lead to the considerations of possible customized therapeutic regimens. Current research is expected to lead to innovative treatments in the near future. [source] Genetics and Neuroscience in Dyslexia: Perspectives for Education and RemediationMIND, BRAIN, AND EDUCATION, Issue 4 2007Gerd Schulte-Körne ABSTRACT , Our understanding of the causes of a developmental disorder like dyslexia has received recent input from both neuroscience and genetics. The discovery of 4 candidate genes for dyslexia and the identification of neuronal networks engaged when children read and spell are the basis for introducing this knowledge into education. However, the input from educational practitioners as well as empirical knowledge from research on learning also contribute significantly to our understanding of how children acquire the basic skills for learning to read and spell. It is imperative to merge the knowledge acquired from research in the fields of neuroscience, genetics, and empirical education, as well as to understand how the learning brain and instruction interact. Doing so can be seen as a major step in attaining an optimal approach for teaching, reading, and spelling and for finding the best suited and most effective treatment concepts for dyslexic children and adolescents. [source] Biodegradable polymers applied in tissue engineering research: a reviewPOLYMER INTERNATIONAL, Issue 2 2007Monique Martina Abstract Typical applications and research areas of polymeric biomaterials include tissue replacement, tissue augmentation, tissue support, and drug delivery. In many cases the body needs only the temporary presence of a device/biomaterial, in which instance biodegradable and certain partially biodegradable polymeric materials are better alternatives than biostable ones. Recent treatment concepts based on scaffold-based tissue engineering principles differ from standard tissue replacement and drug therapies as the engineered tissue aims not only to repair but also regenerate the target tissue. Cells have been cultured outside the body for many years; however, it has only recently become possible for scientists and engineers to grow complex three-dimensional tissue grafts to meet clinical needs. New generations of scaffolds based on synthetic and natural polymers are being developed and evaluated at a rapid pace, aimed at mimicking the structural characteristics of natural extracellular matrix. This review focuses on scaffolds made of more recently developed synthetic polymers for tissue engineering applications. Currently, the design and fabrication of biodegradable synthetic scaffolds is driven by four material categories: (i) common clinically established polymers, including polyglycolide, polylactides, polycaprolactone; (ii) novel di- and tri-block polymers; (iii) newly synthesized or studied polymeric biomaterials, such as polyorthoester, polyanhydrides, polyhydroxyalkanoate, polypyrroles, poly(ether ester amide)s, elastic shape-memory polymers; and (iv) biomimetic materials, supramolecular polymers formed by self-assembly, and matrices presenting distinctive or a variety of biochemical cues. This paper aims to review the latest developments from a scaffold material perspective, mainly pertaining to categories (ii) and (iii) listed above. Copyright © 2006 Society of Chemical Industry [source] Clinical Experiences of Computer Numeric Control-Milled Titanium Frameworks Supported by Implants in the Edentulous Jaw: A 5-Year Prospective StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2004Anders Örtorp DDS ABSTRACT Background: Few long-term follow-up studies on treatment concepts using computer numeric control-milled titanium frameworks have been conducted. Objective: To evaluate the clinical and radiographic performance of implant-supported prostheses provided with computer numeric control-milled titanium frameworks in the edentulous jaw and to compare their performance during the first 5 years of function with that of prostheses provided with conventional cast gold alloy frameworks. Materials and Methods: A consecutive group of 126 edentulous patients were randomly provided with 67 prostheses with titanium frameworks (test group) in 23 upper jaws and 44 lower jaws and with 62 conventional prostheses with gold alloy castings (control group) in 31 upper jaws and 31 lower jaws. Clinical and radiographic 5-year data were collected for the test and control groups. Results: The frequency of problems was low, and clinical and radiologic performances were similar in both groups. In the test group, the 5-year cumulative survival rates (CSRs) were 94.9% and 98.3% for implants and titanium prostheses, respectively. The respective corresponding CSRs for the control group were 97.9% and 98.2%. More loaded implants were lost in the maxillas in the test group (p < .01), but this difference was not significant on the patient/prosthesis level (p > .05). Smokers lost more implants than nonsmokers lost (p < .01). Similar survival rates were observed for implants in the mandible. One prosthesis was lost in each group because of the loss of implants. Metal fractures were seen only in the control group, and resin veneer fractures were more frequent in the maxilla in the gold alloy group (p < .05). In the test group, the mean marginal bone loss was 0.5 mm (SD, 0.44) in the maxilla and 0.4 mm (SD, 0.50) in the mandible. A similar pattern of bone reaction was observed in the control group. Mean marginal bone loss was similar for smokers and nonsmokers (p > .05). Conclusion: Computer numeric control-milled titanium frameworks are a viable alternative to gold alloy castings in the edentulous jaw and present clinical and radiologic performances similar to those of conventional gold alloy frameworks during the first 5 years of function. [source] | ||||||||||