bluuebunny/crossref_metadata_2025 huggingface dataset:
A previous abrasion in the contralateral eye influences the cell kinetics during healing of a central corneal abrasion
Authors: Estil Svein , Haaskjold Erling , Bjerknes Rolf , Refsum Sigvald B.
Published: March 2003

ABSTRACT. Purpose: To study the influence of a previous erosion in the fellow eye on the proliferative response during healing of a central corneal erosion.

Methods: A corneal abrasion was made on the right eye of 20 rats. After 1 week a corneal erosion was made in the left eye of the pre‐treated animals and in 20 previously untreated animals. Cell kinetic methods were used to estimate the labelling index (LI) and the mitotic rate (MR) after 1, 2, 4, 6 and 12 days.

Results: After 24 hours the corneal erosions were covered by epithelial cells in 3 of 4 animals in both groups. The LI and the MR were significantly higher in the pre‐treated group on the 2nd day after erosion.

Conclusions: The proliferation measured by LI and MR was increased when an abrasion was made in the contralateral eye 1 week earlier. This might explain the faster healing rate of the second eye reported by other authors (Rask et al. 1996). The healing process in the cornea is modulated by systemic influence.
Polarimetric nerve fiber analysis in patients with peripapillary myelinated retinal nerve fibers
Authors: Tatlıpınar Sinan , Gedik Şansal , Mocan M. Cem , Orhan Mehmet , İrkeç Murat
Published: March 2003

ABSTRACT. Purpose: The aim of this study was to compare the RNFL thickness in eyes with myelinated retinal nerve fibers (MRNF) and age, sex‐matched controls using scanning laser polarimetry.

Methods: Seventeen patients with MRNF underwent a comprehensive ophthalmological examination including automated visual field testing, and scanning laser polarimetry with Nerve Fiber Analyser (NFA II). Twenty eyes with MRNF from 17 patients were available for the study. Sixteen healthy, age and sex‐matched subjects were taken as controls. Retinal nerve fiber thickness measurements of the four sectors (superior, inferior, nasal, temporal) and along the whole circumference of the optic disc were obtained for affected and control eyes, and compared.

Results: Inferior average and inferior integral parameters of the NFA revealed significantly thinner RNFL thickness measurements in eyes with inferiorly located MRNF compared to controls.

Conclusion: Retinal myelination alters the birefringent property of the RNFL, and results in diminished thickness measurements. Hence, NFA measurements in patients with MRNF may not be reliable.
Long‐term follow‐up of idiopathic central serous chorioretinopathy without laser
Authors: Bujarborua D.
Published: March 2003

ABSTRACT. Purpose: The purpose of this study was to observe the varied types of manifestations in the fundus of patients with idiopathic central serous chorioretinopathy (ICSC) without laser treatment and also to assess the ultimate visual outcome in such cases in a long‐term follow‐up ranging from 7 to 23 years.

Methods: This study is confined to 5 selected cases of ICSC which fairly represent the different types of late stage manifestations of the disease in the fundus. Case records from our hospital, as well as available records of previous treatment elsewhere were reviewed. A complete ophthalmological examination, routine laboratory investigations and fluorescein fundus angiography (FFA) were repeated in each case on the day of final evaluation.

Results: Pigmentary disturbances in the macular area resembling to some extent age‐related macular degeneration (AMD), extensive retinal pigment epithelial (RPE) atrophy and macular haemorrhage have been observed in the fundus of the reviewed cases.

Conclusions: ICSC runs an unpredictable course and there are no definitive clinical clues to predict its ultimate outcome. Recurrence of the condition is a possibility for a considerable period of time.
Healing of recurrent herpes simplex corneal epithelial lesions treated with topical acyclovir
Authors: Tabery Helena M.
Published: March 2003

ABSTRACT. Purpose: To examine morphological changes occurring in recurrent herpes simplex virus (HSV) epithelial keratitis after the application of topical acyclovir ointment 3%.

Material and methods: 7 patients examined with the slit lamp and photographed by non‐contact in vivo photomicrography.

Results: Within one day of treatment the lesions lost their typical herpetic features, and after about 2–3 days the morphology seemed to reflect only the sequelae: unhealthy epithelium and abnormal cells located at the level of the basement membrane. Two patients showed epitheliopathy compatible with the side‐effects of the treatment.

Conclusions: The rapid loss of typical HSV features after drug application reflects a successful arrest of the virus replication, freeing the epithelial healing forces. At what point of time infectious virus is eradicated and the treatment can be safely stopped cannot be determined clinically. Healing in the sense of restitution ad integrum is a slow process showing individual variations. Abnormal intra‐/subepithelial cells are last to disappear.
Additive IOP‐reducing effect of latanoprost in patients insufficiently controlled on timolol
Authors: Bron Alain M. , Denis Philippe , Nordmann Jean‐Philippe , Rouland Jean‐François , Sellem Eric , Johansson Marianne
Published: March 2003

ABSTRACT. Purpose: To evaluate the effect on intraocular pressure (IOP) of switching from timolol to latanoprost or adding latanoprost to timolol in patients with open angle glaucoma or ocular hypertension where IOP is not adequately controlled with timolol.

Methods: This was a 6‐week, double‐masked, randomised multi‐centre study. 53 patients with primary open angle glaucoma, capsular glaucoma, or ocular hypertension with an IOP of at least 21 mmHg on current therapy were recruited. After a run‐in period of at least 2 weeks on timolol, 5 mg/ml twice daily, patients were randomised to one of three groups. One group continued on timolol, one switched from timolol to latanoprost, 50 μg/ml once daily, and a third group received latanoprost in addition to timolol. The efficacy was evaluated by comparing IOP at 9 AM at baseline and after 6 weeks of treatment.

Results: IOP at baseline and after 6 weeks of treatment (mean±SEM) were 24.2±0.9 and 23.8±1.0 mmHg (n=16) for patients continuing on timolol, 26.3±1.2 and 19.6±1.1 mmHg (n=17) for patients switching to latanoprost, and 23.2±1.0 and 17.5±0.8 mmHg (n=17) for patients with combined treatment. Adding latanoprost to timolol reduced IOP with 5.9±0.9 mmHg (p<0.001) and switching from timolol to latanoprost reduced IOP with 5.0±0.9 mmHg (p<0.001), which caused in each group a significant IOP reduction of about 25%.

Conclusions: The effect of latanoprost was additive to that of timolol, and a good effect on IOP reduction was also achieved by switching from timolol to latanoprost, suggesting that a switch in many patients is an effective alternative to combination treatment.
Ocuton‐S self tonometry vs. Goldmann tonometry; a diurnal comparison study
Authors: Kóthy Péter , Vargha Péter , Holló Gábor
Published: March 2003

ABSTRACT. Purpose: To compare 24‐hour diurnal intraocular pressure (IOP) measurements obtained using the Ocuton‐S applanation self tonometer and the Goldmann tonometer.

Methods: 24‐hour diurnal IOP curves were obtained on 14 eyes of 7 trained patients suffering from medically controlled primary open angle glaucoma. IOP was measured every third hour starting at 9 a.m. with a calibrated Goldmann tonometer; one week later, a similar set of measurements was obtained with Ocuton‐S self tonometry by the patients. One week later still, ultrasound corneal pachymetry was performed at the same hours.

Results: Overall IOP (24‐hour mean) did not differ significantly between the different measuring techniques (ANOVA, p=0.74), but the IOP differed in a statistically significant manner around the clock (ANOVA, p=0.00006). The mean Goldmann tonometric readings were up to 2.8 mmHg lower than the Ocuton‐S values during the daytime (9 a.m. to 9 p.m.), however, during the night (12 midnight to 6 a.m.) mean IOP measured with Goldmann tonometry was 2.2 to 3.3 mmHg higher than the corresponding average of the self tonometry readings. There was a statistically significant interaction between the type of tonometry and the time of the measurement (p=0.0007). Central corneal thickness (CCT) showed a significant change during the 24‐hour period (p=0.000001).

Conclusion: IOP shows a different diurnal curve when measured with the Goldmann tonometer and with the Ocuton‐S applanation self tonometer. The instruments’ readings might be influenced in different ways by the diurnal changes of the corneal thickness. Since Ocuton‐S self tonometry underestimates the IOP in the early morning period, a careful evaluation is necessary when nocturnal and early morning IOP elevation is investigated with this technique.
Scedosporium apiospermum chorioretinitis
Authors: Kıratlı Hayyam , Uzun Ömrüm , Kiraz Nuri , Eldem Bora
Published: March 2003

Purpose: A case of a 24‐year‐old immunocompetent woman who developed unilateral Scedosporium apiospermum chorioretinitis and diffuse cervical lymphadenitis 10 years after facial steroid injection is described.

Methods: The patient was initially treated for the misdiagnosis of tuberculous lymphadenitis. Contemporaneous to the enlargement of her lymph nodes, she experienced gradual loss of vision in her left eye. She subsequently underwent lymph node biopsy.

Results: Histopathologic sections stained with Grocott’s methenamine silver showed branched septate hyphae and cultures on Sabouraud’s agar yielded Scedosporium apiospermum. The patient received oral itraconazole 200 mg twice daily. Lymphadenitis regressed within a year and chorioretinitis scarred within two years.

Conclusion:
Scedosporium apiospermum
may cause isolated chorioretinitis in an immunocompetent individual years after local surgery or trauma and result in significant visual morbidity. Treatment may require prolonged use of systemic itraconazole.
Biometric measurements of the eyes in teenagers and young adults with Down syndrome
Authors: Haugen Olav H. , Høvding Gunnar , Eide Geir Egil
Published: March 2003

Purpose: To examine ocular biometric variables in subjects with Down syndrome.

Methods: In a population‐based study we have compared ocular biometric variables in a group of 47 individuals with Down syndrome (20.0±3.9 years) with 51 control subjects (21.0±4.6 years).

Results: A thinner cornea (0.48±0.04 mm vs. 0.55±0.03 mm, p<0.001) and higher keratometry values (46.39±1.95 D vs. 43.41±1.40 D, p<0.001) were found in the Down syndrome group than in the control group. Oblique astigmatism was commonly found in the Down syndrome individuals, showing a strong right‐left specificity (right eyes’ axes in the 135°‐meridian, left eyes’ axes in the 45°‐meridian). The lens was thinner (3.27±0.29 mm vs. 3.49±0.20 mm) and the calculated lens power was weaker (17.70±2.36 D vs. 19.48±1.24 D) in the Down syndrome group than in the control group (p<0.001 in both cases).

Conclusions: Thinning of the corneal stroma may account for the steeper cornea and the high frequency of astigmatism in Down syndrome due to lower corneal rigidity. It may also be of etiological importance to the increased incidence of keratoconus in Down syndrome.
Results with a modified method for scleral suturing of intraocular lenses
Authors: Behndig Anders
Published: March 2003

Purpose / methods: The long‐term results obtained by a modified method of scleral suturing of posterior chamber lenses (PCLs) (Behndig & Otto 1997) were retrospectively registered and evaluated. Forty‐four patients with insufficient capsular support for ordinary PCL implantation were included. Mean follow‐up time was 13.1 ± 6.4 months and registered parameters included visual acuity, deviation from planned refractive outcome, induced astigmatism, and complications.

Results / conclusions:
The results were comparable to those reported earlier for this type of surgery. It has previously been stated that scleral suturing of posterior chamber lenses is a safe procedure with good long‐term results. This modified method produces comparable results while being more surgically simple and reproducible.
Ocular ochronosis: A case report and clinical findings
Authors: Söker Çakmak Sevin , Çevik Remzi , Aksünger Ahmet , Ünlü Kaan , Ava Sedat
Published: March 2003

Purpose:  To report a rare case of bilateral asymmetrical melanin‐like pigments found in the cornea, conjunctiva and sclera.

Methods:  Systemic investigation with clinical and laboratory analysis.

Results:  The case was diagnosed as one of alkaptonuria and ocular ochronosis.
Photoreceptor survival in transplantation of autologous iris pigment epithelial cells to the subretinal space
Authors: Crafoord Sven , Geng Lijun , Seregard Stefan , Algvere Peep V.
Published: March 2003

Purpose:  To investigate photoreceptor survival in transplantation of non‐cultured iris pigment epithelial (IPE) cells to the subretinal space in a prospective experimental study.

Methods:  Upper iridectomies were carried out in the right eyes of 37 pigmented rabbits. Suspensions of freshly harvested autologous IPE cells (without culturing) were prepared and injected into the subretinal space of the same eye. Follow‐up examinations were carried out using ophthalmoscopy and colour fundus photography. The rabbits were killed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy.

Results:  On histological examination, the photoreceptor cells were found to be well‐preserved in grafted areas at 1–3 months. At 6 months, the photoreceptors generally disclosed a normal nuclear layer and long outer segments when overlying areas with single cells or clusters of transplanted IPE cells. Multilayers of cells in abundance, including native RPE cells and macrophages (stained with RAM 11), particularly under microfolds of the neural retina, were occasionally associated with photoreceptor damage and nuclear drop out from the outer retinal layer. There was no inflammatory response in the choroid and the choriocapillaris remained patent.

Conclusion:  The experiments show that grafting freshly harvested autologous IPE cells to the subretinal space is feasible and that the photoreceptors generally survive for at least 6 months when overlying the transplanted areas. Multilayers of abundant cells in the subretinal space may induce adverse focal effects on adjacent photoreceptors.
Neuroendocrine differentiation in gastric adenocarcinomas associated with severe hypergastrinemia and/or pernicious anemia
Authors: Qvigstad Gunnar , Qvigstad Tor , Westre Bjørn , Sandvik Arne K. , Brenna Ejliv , Waldum Helge L.
Published: March 2003

Patients with hypergastrinemia secondary to achlorhydria have an increased risk of developing ECL cell carcinoids and gastric adenocarcinomas. Hypergastrinemia is central in the pathogenesis of ECL cell carcinoids, but the link between gastrin and gastric carcinomas is controversial. During neoplastic transformation ECL cells may, however, lose many of their neuroendocrine characteristics, making them difficult to recognise as neuroendocrine with conventional immunohistochemical techniques. Neuroendocrine differentiation was therefore examined in eight gastric adenocarcinomas found in seven patients with severe hypergastrinemia and/or pernicious anemia using a monoclonal antibody towards chromogranin A and immunohistochemistry without and with a sensitive signal amplification technique. The Sevier‐Munger method was used as a more specific marker of ECL cells. Seven of the carcinomas contained scattered neuroendocrine tumour cells. When using signal amplification, an increase in the number of immunoreactive neoplastic cells was seen. In many tumours, clusters or confluent sheets of such cells were disclosed, suggesting a neuroendocrine and ECL cell origin. These tumours may therefore be ECL cell carcinomas and hypergastrinemia may thus be involved in the tumourigenesis.
Non‐small cell lung cancers frequently express phosphorylated Akt; an immunohistochemical study
Authors: Lee SUG HYUNG , Kim HONG SUG , Park WON SANG , Kim SU YOUNG , Lee KYO YOUNG , Kim SANG HO , Lee JUNG YOUNG , Yoo NAM JIN
Published: March 2003

Mounting evidence suggests that the alterations of Akt/protein kinase B (PKB) play an important role in tumorigenesis. Phosphorylated Akt regulates many of the key effector molecules involved in apoptosis, angiogenesis, and cell cycle progression during tumorigenesis. The expression of phosphorylated Akt has been described in some human malignancies, but not in primary human lung cancer. In this study, to understand the role of Akt in lung tumorigenesis we analyzed the expression of phosphorylated Akt in 43 non‐small cell lung cancers (NSCLCs) by immunohistochemistry. Phosphorylated Akt was detected either in the cytoplasm (23 cases) or nucleus (6 cases) in 29 of 43 NSCLCs (67.4%). Squamous cell carcinomas, adenocarcinomas, and bronchioloalveolar carcinomas expressed phosphorylated Akt in 68.2%, 61.5% and 75%, respectively. We also analyzed the phosphorylated Akt expression between primary NSCLCs and their corresponding nodal metastasis; the expression was not, however, different between the primary and metastatic lesions. Taken together, these results indicate that Akt 1 is frequently activated in NSCLCs, irrespective of the histological subtypes, and suggest that phosphorylated Akt may play a role in the development of NSCLC rather than in the progression of NSCLC.
Hepatitis B virus infection in drug addicts: no acute fatalities, no chronicity and could have benefits
Authors: Gjeruldsen S. , Myrvang B.
Published: March 2003

In a group of 159 drug addicts with acute hepatitis B in the 1970s there were no fatalities. During an observation period of about 25 years, 51 of the 159 died of various causes, but no deaths could be attributed to the hepatitis B infection. From 1998 to 2001, a follow‐up examination of 53 of the 108 patients still alive, none of the 53 had a chronic hepatitis B virus infection. Fifteen out of thirty‐five patients who had completely stopped using narcotics claimed that hospitalisation for acute hepatitis B had been an important factor in their decision to quit drugs.
Bacillarity at autopsy in pulmonary tuberculosis
Authors: Lillebaek Troels , Kok‐Jensen Axel , Viskum KAJ
Published: March 2003

The aim of this investigation was to quantify dissemination of Mycobacterium tuberculosis infection in patients with pulmonary tuberculosis and to show the pattern of eradication during treatment. The study is based on 98 out of the 113 patients with pulmonary tuberculosis who died during their admission to hospital in the Municipality of Copenhagen from 1963 to 1971. These patients had cultures for M. tuberculosis performed from different organs at autopsy: 78% treated <=100 days had dissemination of bacteria, cultured with decreasing frequency in the lungs, spleen, liver, and kidneys, respectively. In comparison, 23% treated >100 days had dissemination of bacteria, among which 50% occurred in patients with records of poor treatment compliance, 14% in patients with good treatment compliance. 81% of all patients had at least one chest x‐ray judged to be without a miliary pattern. This study emphasizes that M. tuberculosis is often disseminated to organs other than the lungs in severe pulmonary tuberculosis. Eradication of bacteria in these organs can take several months. This observation adds to our understanding of the natural history of tuberculosis: M. tuberculosis is a resilient organism that can adapt to a wide variety of environmental conditions.
Quality of fetal, perinatal and infant autopsy reports. An audit of all reports of postmortem examinations following fetal, perinatal and infant deaths in Rogaland County, Western Norway, 1997–1999
Authors: BJUGN ROGER , BERLAND JANNICKE
Published: March 2003

The aim of the present study was to investigate the quality of fetal, perinatal and infant (< 12 months of age) autopsy reports. One hundred and thirty‐six reports were scored for seven major categories (History, External description, Internal examination, Histology report, Other investigations, Placenta, Conclusions/Commentary) derived from “Guidelines for post mortem reports” published by the Royal College of Pathologists. The time taken for the final reports to be issued was also investigated. Of the 136 reports, 31 failed to reach a minimum standard of a 50% score. The one major category clearly falling below the recommended standard was Conclusions/Commentary. Other major categories such as History, External description and Histology report were also in need of improvement. Only three final reports were issued within the Department of Pathology's goal of 4 weeks. Although 77% of the reports fulfilled a minimum standard of a 50% score, the audit clearly showed that the standardised report form used was in need of revision and that many reports failed to give the clinicians an evaluation of the data presented in the autopsy reports. Based on the present findings, a number of measures have been implemented in order to improve the quality of future fetal, perinatal and infant autopsy reports.
Morules with optically clear nuclei in ovarian borderline endometrioid tumor
Authors: LI CHIUN CHEI , HIROKAWA MITSUYOSHI , QIAN ZHIRONG , FUJII YOSHIYUKI , INO HIROYASU , WAKATSUKI SHINGO , HORIGUCHI HIDEHISA , KAGAWA NORIKO , SANO TOSHIAKI
Published: March 2003

Optically clear nuclei (OCN) have been observed in morules of some neoplasms and in some conditions unrelated to the development of the morules. We first report a case of ovarian borderline endometrioid tumor (BET) showing the morules associated with OCN. The patient was a 47‐year‐old premenopausal woman with a left ovarian cystic tumor, atypical endometrial hyperplasia, and elevated serum levels of FSH, LH, estradiol, and CA 125. The resected ovarian tumor measured 6 cm in diameter, and showed a papillary growth. Histologically, the ovarian tumor was consistent with BET, and the morules with OCN were scattered. Immunohistochemically, OCN were proven to be rich in biotin. An aberrant nuclear expression of beta‐catenin was observed in both the tumor cells and the morular cells. Our case may suggest the possibility that the appearance of OCN with or without morules in ovarian tumors is related to endometrioid differentiation of the tumor cells, and should be recognized as a diagnostic clue of ovarian endometrioid tumors. Although female sex hormones have been reported to play a role in the occurrence of OCN, the participation of beta‐catenin mutation has also been suggested.
Microbial differences in 2 clinically distinct types of failures of osseointegrated implants
Authors: Sanz M. , Alandez J. , Lazaro P. , Calvo J. L. , Quirynen M. , Van Steenberghe D.
Published: March 2003

This investigation is the result of a multicenter research project between the Catholic University of Leuven and the University of Madrid with the purpose of studying histometrically and ultrastructurally periimplant marginal tissue reactions in medium‐term Brånemark implants. 12 patients were selected and distributed according to predefined clinical and radiological parameters into a periimplant infection group (A) and a non‐periimplant infection group (B). Biopsies were taken from these patients and analyzed by means of microscopy (LM), histometry (HM) and transmision electron microscopy (TEM). With LM group A showed pathological features consistent with an advanced gingivitis lesion, while group B showed signs of healthy gingiva in the connective tissue and vauolae formation in the epithelium. With HM, group A showed significantly higher transmigration of inflammatory cells in the epithelium than group B. In the connective tissue, group A showed a higher % of inflammatory infiltrate with significantly higher numbers of plasma cells and mononuclear cells than group B. With TEM, group A showed an ultrastructural picture consistent with plaque‐induced periodontitis, while group B showed a rather healthy connective tissue and vacuolae formation in the epithelium. These results suggest that supra‐crestal marginal tissues around osseointegrated implants react to plaque bacteria similarly to periodontal tissues around teeth by chronic inflammation.
Supracrestal circular collagen fiber network around osseointegrated nonsubmerged titanium implants
Authors: Rugger A. , Franchi M. , Marini N. , Trisi P. , Piattelli A.
Published: March 2003

Eight non‐submerged titanium implant screws were placed in the first upper molar edentulous sites of monkeys and subsequently kept loaded with single crown prosthesis 1 month following implantation. The animals were killed after a further 14 months and specimens including implant and adjacent teeth were processed for light and electron microscopy. Histological pictures of all samples showed the neck and most of the screw body to be surrounded by new bone. The soft tissue surrounding the implant post included pocket epithelium and supra‐crestal connective tissue displaying collagen fiber bundles comparable to gingival ligaments. These peri‐implant collagen fiber bundles arose from the neighboring alveolar crest, root cementum of adjacent teeth or, superficially, from the epithelium and followed a circular array around the implant neck.
Membrane permeability is unnecessary for guided generation of new bone. An experimental study in the rabbit.
Authors: Schmid J. , Hämmerle C. H. F. , Olah A. J. , Lang N. P.
Published: March 2003

The aim of this investigation was to test the hypothesis that membrane permeability is necessary in bone formation using the principle of guided tissue regeneration. On the forehead of 8 rabbits. titanium test cylinders were anchored in the calvaria. These cylinders were either covered by an expanded polytetrafluoroethylene (e‐PTFE) membrane generating a chamber for bone formation or they were sealed off by cast titanium. The implanted cylinders were covered by resuturing the periosteum and the cutaneous flap. After 8 months of healing. new bone had formed in all cylinders in all animals irrespective of whether the chamber for bone formation was sealed off by cast titanium or the e‐PTFE membrane. Based on these results, we conclude that permeability of the membrane is not necessary in the guided generation of new bone.
Clinical evaluation of guided bone regeneration at exposed parts of Brånemark dental implants with and without bone allograft
Authors: Mattout P. , Nowzari H. , Mattout C.
Published: March 2003

This investigation evaluated guided bone regeneration with a polytetrafluoroethylene barrier membrane at exposed parts of Bråemark dental implants with and without concomitant use of decalcified freeze‐dried bone allograft. Density of the regenerated tissue was also determined using a No. 23 probe at a pressure of 25g and was graded from 1 to 5. The higher index was associated with a higher resistance of newly formed tissue to the pressure of the probe. In 19 patients, 23 defects were treated by barrier membrane alone and 11 defects by bone allograft with barrier membrane. The width and the depth of the defects were determined at the time of the implant placement and at the second‐stage implant surgery. When success was defined as 0 mm of residual defect, the mean success rate was 68% for the membrane group and 90% for the membrane group with bone allograft, with no statistically significant difference between the two treatment groups. The two groups did not demonstrate a significant difference in median density index. There was a significant positive relationship between time of membrane coverage and density index. A density index of 4 was only recorded after 7 months of membrane coverage. The present findings suggest beneficial clinical effect with the use of membrane alone and freeze‐dried bone allograft with membrane for guided bone regeneration. This study proposed the use of a novel density index of clinical evaluation of regenerated tissue.
Long‐term stability of osseointegrated implants in bone regenerted with the membrane technique. 5‐year results of a prospective study with 12 implants.
Authors: Buser D. , Dula K. , Lang N. P. , Nyman S.
Published: March 2003

The purpose of the present clinical study was to evalutate the 5‐year results of the first 12 implants inserted at the University of Berne in regenerated bone following successful ridge augmentation with the membrane technique. The patients were recalled and examined with clinical and radiographic paramenters routinely utilized in prospective studies with standard implants in non‐regenerated bone. Based on clinical and radiographic findings, all 12 implants were considered successfully integrated according to strict criteria of success. The detailed analysis of clinical parameters revealed no differences to results of prospective studies on standard implants in non‐regenerated bone. All implants demonstrated ankylotic stability which was confirmed by a mean Periotest value of ‐2.08. The radiographic analysis showed stable bone crest levels with a mean bone loss between the 1‐ and 5‐year examination of 0.30 mm. However, 2 implants exhibited a bone loss of more than 1 mm between the 1‐ and 5‐year examination. Therefore, the prognosis of these 2 implants seems questionable at the present time. It can be concluded that bone regenerated with the membrane technique reacts to implant placement like non‐regenerated bone, since all 12 implants achieved successful tissue integration with functional ankylosis. Furthermore, this bone is also load‐bearing, since all 12 implants maintained osseointegration over a 5‐year period.
Correlations between radiographic, clinical and mobility parameters after loading of oral implants with fixed partial dentures. A 2‐year longitudinal study.
Authors: Brägger U. , Hugel‐pisoni C. , Bürgin W. , Buser D. , Lang N. P.
Published: March 2003

The aim of the present study was to correlate the changes in the peri‐implant tissues occurring after functional loading of non‐submerged titanium implants and assessed by radiographic, clinical and mobility measurements. 11 patients with distal extension situations received 18 implants of the ITI® Dental Implant System. After a healing period of 3months, the suprastructures were fabricated and seated 5months post‐surgically. For the assessment of peri‐implant bone changes, standardized vertical bitewing radiographs with reproducible exposure geometry were evaluated using computer assisted densitometric image analyses (CADIA) and bone height measurements. Since the radiographic evaluations were performed at mesial and distal sites only, the clinical parameters from these implant aspects were included in the analysis. Clinical periodontal parameters modified for the use around implants were obtained, damping characteristics were expressed as Periotest® readings and standardized radiographs were obtained at 1, 3, 6, 12 and 24 months after loading. In addition, radiographs were also taken at the start of functional loading. The data obtained from this small sample of implants demonstrated a wide range of different tissue alterations when using radiographic. clinical and mobility assessments. The parameter of probing attachment level (PAL) in combination with radiographic parameters obtained at 1, 3 and 6 months after loading were good predictors for the peri‐implant tissue status at 2 years. This was shown by means of multiple stepwise regression analyses. Mobility measurements did not reveal valuable predictive information with the statistical models applied. Assessments of probing attachment levels using periodontal probes rendered information on peri‐implant tissue alterations, which were closely correlated to the radiographically measurable peri‐implant bone changes.
3‐D in vivo force measurements on mandibular implants supporting overdentures. A comparative study.
Authors: Mericske‐stern R. , Piotti M. , Sirtes G.
Published: March 2003

Force transmission onto implants supporting overdentures was measured in viva by means of piezoelectric transducers that allow for simultaneous force registrations in 3 dimensions. The transducers are directly mounted onto the implants, beneath the anchorage device. The force registrations were analyzed with regard to the anchorage device and retention mechanism of overdenture support. The 3 types of denture anchorage were a U‐shaped bar, a round clip‐bar and single telescopes. Forces were measured in the following test situations: maximum force when biting in centric occlusion, maximum bite force during biting on a bite plate, grinding and chewing bread. Multiple regression showed that the vertical component of maximum forces was dependent on the anchorage device and test situation. The transverse components reached 10 to 50% of the vertical force magnitude. With the bite plate in situ maximum forces measured in vertical direction were significantly higher on the ipsilateral implant with telescopes than with bars (p<0.01 and p<0.001). Chewing and grinding resulted in lower vertical forces compared to maximum biting. In transverse dimensions, mainly in the anterior‐posterior direction, registered forces reached magnitudes that resembled the vertical component (50 to 100%). Force magnitudes of chewing and grinding were similar for all three anchorage devices. However, differences were observed between bars and telescopes with regard to the direction of transverse force components. The results of this study do not suggest the preference of one specific anchorage system or retention mechanism for overdenture support. However, rigid bars contribute to load sharing and stress distribution onto the implants.
Clinical probing and radiographic assessment in relation to the histologic bone level at oral implants in monkeys
Authors: Lsidor Flemming
Published: March 2003

Clinical probing level and radiographic bone level were compared to histologic bone level around screw type oral implants in 4 monkeys (Mucaca Fasciculavis). Two implants in each monkey retained a fixed partial prosthesis in supra‐occlusal contact with an antagonizing splint. These implants were brushed 1 x a week and subgingival cleaning was performed 1 x a month. Unloaded implants in the same monkeys were never cleaned and, additionally, a cotton cord was placed around these to promote plaque accumulation. After 18 months, intraoral radiographs of the implants were obtained and probing levels were recorded with a metal probe using a standardized force of 0.2 N (Vivacare TPS Probe) and again using a moderate, unstandardized pressure. Immediately afterwards the animals were sacrificed. Sections, approximately 50 fl thick, of the implants and surrounding tissue were cut. The average probing levels with unstandardized pressure were 1.1 mm and 3.9 mm coronal to the histologic bone levels for implants with plaque accumulation or excessive occlusal load, respectively. With standardized probing force, the difference between the probing levels and histologic bone levels were even larger. The radiographic bone levels were on average only 0.5 mm and 0.1 mm short of the histologic bone levels for the two groups of implants. Only the radiographic bone level revealed a statistically significant correlation with the histologic assessment.
Accuracy of radiographic diagnosis of peri‐implant radiolucencies ‐‐ an in vitro experiment
Authors: Sewerin I. P. , Gotfredsen K. , Stoltze K.
Published: March 2003

The absence of a peri‐implant radiolucency on radiographs is used as a criterion for implant success. The purpose of the present study was to evaluate the accuracy of diagnosing peri‐implant radiolucencies using an experimental model. Astra Tech fixtures were inserted into 20 bony specimens. Later, the fixtures were removed and the prepared cavities were enlarged in 2 steps. The specimens were radiographed under strictly standardized circumstances in the 3 stages (“press‐fit”= simulated osseointegration, and “0.1 mm space” and “0.175 mm space”= simulated connective tissue layer”. All specimens were radiographed with 2 vertical angulations (0" and 15"). Ten observers read the radiographs and evaluated bone‐implant relationship on a 5‐point scale. The interobserver agreement was low. Specificity was remarkably low, and sensitivity was moderate. A significant difference in diagnostic accuracy was found for 0.175 mm peri‐implant space compared to 0.1 mm space. The diagnostic accuracy was found to be highest for 0.175 mm peri‐implant space specimens. It is concluded, that radiography seems to be an unreliable method for diagnosing peri‐implant spaces, although accuracy improved at increasing space widths. Strict orthogonal projection angles did not improve diagnostic accuracy.
Reproducibility of automated periodontal probing around teeth and osseointegrated oral implants
Authors: Christensen Motten M. , Joss Andreas , Lang Niklaus P.
Published: March 2003

Three different probing devices (Audio‐Probe®, Florida‐Probe®, Peri‐Probe®) were tested in order to determine the clinical probing depth (CPD) around clinically stable oral implants and their homologous teeth and to evaluate their reproducibility. In all 37 patients. in the age range of 24–80 years, who had undergone periodontal therapy and placement of 1 or more oral implants (ITI®), were selected for the study. The CPD was determined on 75 oral implants in total and at 4 sites of both the implants and the control teeth at 3 visits, each 1 week apart. At the 1st visit, the Florida‐Probe® and the Audio‐Probe® were used. At the 2nd visit, the Florida‐Probe® and the Peri‐Probe® and, at the 3rd visit, again, the Florida‐Probe® and the Audio‐Probe® were used. At each visit bleeding on probing (BOP) was registered. A statistically significant (P<0.05) difference between the mean scores of implant and tooth sites was found showing slightly higher values for implant sites. A tendency for the deeper pockets to bleed more frequently than the shallow pockets was observed. The comparisons of differences of the readings of the Audio‐Probe® on 2 different occasions were smaller than for the Florida‐Probe®. However, comparisons between 2 different probes showed significantly greater measurement errors than when comparing the probes alone. There was a tendency for the Peri‐Probe® to yield the highest and the Audio‐Probe® the lowest values in inflamed sites. It was concluded that all 3 probing devices appeared to have adequate reproducibility both around teeth and oral implants. For clinical use in daily practice, the Audio‐Probe® was found to be the most simple device with the highest 1 reproducibility.
Osseointegration of dental implants in bone irradiated with 40, 50 or 60 Gy doses. An experimental study with beagle dogs.
Authors: Asikainen Pekka , Klemetti Esa , Kotilainen Risto , Vuillemin Thierry , Sutter Franz , Voipio Hanna‐marja , Kullaa Arja
Published: March 2003

Construction of different kinds of prostheses on irradiated bone tissues after tumour surgery is a complicated part of modem implantology. In irradiated regions of the jaws where the bone layers are thin and the blood supply also is minimal, knowledge of the impact of each dose of radiation is very important. The aim of this study was to compare the bone response around titanium implants loaded with fixed bridges in dog mandibles irradiated with total doses of 40, 50 or 60 Gy. The results suggest that after irradiation with 40–50 Gy, when the dose is fractioned in order to achieve higher tolerance of the tissues compared with single dose irradiation, titanium implants may become osseointegrated in the mandibles. For high success rates, however, careful planning of radiotherapy and selection of implantation site with an adequate blood supply are essential.
A meta‐analysis of implants in partial edentulism
Authors: Lindh Tomas , Gunne Johan , Tillberg Anders , Molin Margareta
Published: March 2003

A meta‐analytic technique was used to estimate the survival of implants supporting bridges or single crowns in partially edentulous patients. A survey of the literature revealed 66 studies, published between 1986 and 1996. Nine studies on single implants and 10 studies on fixed partial dentures met the inclusion criteria for the meta‐analysis. Data from a total of 2686 implants, 570 single crowns (SC) and 2116 in fixed partial dentures (FPD). were analyzed. In order to calculate annual survival rates for individual studies a life‐table analysis was conducted. Maximum follow‐up time ranged between 1 and 8 years. After 1 year the success rate was calculated to be at least 85.7% for FPD and 97.2% for SC. When the results from the FPD studies were pooled the survival rate was 93.6% after 6–7 years. The corresponding value for SC was 97.5%.
The influence of cortical perforations and of space filling with peripheral blood on the kinetics Of guided bone generation. A comparative histometric study in the rat.
Authors: Rompen Eric H. , Biewer Robert , Vanheusden Alain , Zahedi Sharham , Nusgens Betty
Published: March 2003

The aim of the present study was to evaluate the influence of cortical perforations and of peripheral blood addition in guided bone generation beyond the skeletal envelope in rats. A total of 30 isogenic adult rats were divided into 3 equal groups. In each rat, two hollow parallelipipedic titanium chambers were placed bilaterally on the calvaria after a periosteal skin flap was raised. While on the right sides (controls) the osseous surface was left intact and the chambers were empty. the cortical bone under the left‐side chambers (test sites) was perforated with nine 0.8 mm‐diameter holes (group I), or left intact but with the chambers filled with a clot of peripheral blood (group II). In group III, both procedures were combined in the test sites. The healing was assessed at 4, 8 and 16 weeks after surgery by histologic and computer‐assisted histometric analysis. The results demonstrated a substantial augmentation of on average 141%(SD 18 of the skull's thickness after 16 weeks in the controls. indicating that a predictable bone formation can be achieved beneath completely occlusive barriers over a non‐injured cortical layer. In all test groups, a significantly larger bone augmentation was observed after 16 weeks compared to the control sites: 172.8%(SD 41.7) in group I (P<0.05) 172.0%(SD 18.4) in group II (P<0.05) and 221.5%(SD 42.3) in group III (P<0.00l), demonstrating that stimulating blood supply and bone forming cells access by cortical perforations and/or blood clot addition enhances de novo bone formation in this experimental model.
Attempts to obtain re‐osseointegration following experimental peri‐implantitis in dogs
Authors: Wetzel Anton C. , Vlassis James , Caffesse Raul G. , Hämmerle Christoph H. F. , Lang Niklaus P.
Published: March 2003

The purpose of this study was to examine the healing potential and re‐osseointegration in peri‐implant infection defects adjacent to various implant surfaces. In 7 female Beagle dogs, a total of 41 titanium oral implants (ITI, Straumann, Waldenbur, Switzerland) with a sink depth of 6 mm (diameter 2.8 mm) were placed transmucosally. Four different surface configurations (TPS: titanium plasma sprayed (10); SLA: sand blasted and acid‐etched (13); M: machined and smooth (11); TPS furc.: titanium plasma sprayed with coronally placed perforation to mimic a furcation (7) were distributed among the animals and locations. Following a healing period of 3 months, silk ligatures were placed and oral cleaning procedures abolished for 4 months to induce a vertical bone loss of about 40%. Following mechanical and chemical cleansing (chlorhexidine and metronidazole)and disinfection. the lesions were either sham operated (11) or subjected to a GTR procedure using ePTFE (30). After 6 months of healing the animals were killed and the jaws histologically evaluated. Six membranes were lost TPS: (1); SLA: (2); M: (2); TPS furc: (1) and 3 membranes exposed TPS: (1); M: (2) and excluded from further evaluation. Owing to the loss of 1 implant and infection of the membranes in the TPS furc group, this implant configuration was discarded from further analysis. For TPS surfaces, bone fill was 2.6 mm (73% of the distance from the bottom of the defect to the shoulder of the implant) sites with (4 GTR) and 0.33 mm (14%) for sites without membrane (2 controls). Re‐osseointegration was 0.5 mm (14%) in the test group and 0.3 mm (14%) in the control. For SLA surfaces bone fill was 2.3 mm (83%) for sites with (7 GTR) and 0.41 mm (15%) for sites without membranes (4 controls). Re‐osseointegration was 0.6 mm (20%) and 0.3 mm (11%) respectively. Corresponding values for M surfaces were 2.2 mm (62%) with 4 GTR) and 0.82 mm (31%) without membranes. Re‐osseointegration was 0.07 mm (2%) and 0.19 mm (7%) respectively. This study has documented that peri‐implant infections defects may heal with bone fill provided that the infection is controlled through effective antibacterial therapy. However, true reosseointegration appears to be difficult to achieve.
Interdisciplinary treatment planning for orthodontic‐prosthetic implant anchorage in a partially edentulous patient
Authors: Willems Guy , Carels Carine Emma Louis , Naert Lgnace Eugene , Van Steenberghe Daniel
Published: March 2003

Successful orthodontic treatment is characterized by optimal anchorage control. Teeth or groups of teeth are united to counteract biomechanical reactive forces during orthodontic treatment. These classic anchorage control mechanisms are less efficient or even non‐existent in partially edentulous patients who are missing multiple posterior teeth. However, osseointegrated oral implants ad modum Br‐vemark can provide optimal anchorage control for orthodontic tooth alignment and rehabilitation of occlusion through prosthetic implant restorations. Careful multidisciplinary planning based on complex diagnostic wax setup casts to determine exact implant location and orientation in line with future orthodontic tooth displacements and prosthetic implant crown restorations is the most important step in the overall treatment planning.
Immediate functional loading of Brånemark single tooth implants
Authors: Ericsson Ingvar , Nilson Hans , Lindh Thomas , Nilner Krister , Randow Kjell
Published: March 2003

A clinical and radiographical study was performed to evaluate the treatment outcome of single tooth replacements with artificial crowns retained to implants installed according to a 1‐stage surgical procedure and immediate loading (Experimental Group=EG) in comparison to the original 2‐stage concept (Control Group=CG). The EG comprised 14 patients (=14 implants) and the CG comprised 8 patients (=8 implants), all with single tooth losses anterior to the molars. Beyond the non‐smoking criterion the following criteria were adopted: i) the amount of bone had to allow for installation of a fixture with a minimum length of 13 mm and ∅=3.75 mm, ii) the jaw relationship had to allow for bilateral occlusal stability, iii) the patients should be judged to be non‐bruxers, and iv) the patients had to be available for the follow‐up and maintenance programme. In the EG a temporary crown was connected to the implant within 24 h following fixture installation. Six months later this crown was replaced with a permanent one. In the CG the surgical and prosthetic treatment followed the standard protocol. Out of the 14 fixtures in the EG 2 were lost up to 5 months in function and were subsequently removed. All remaining 12 implants were stable at every subsequent follow‐up examination. No fixture losses were recorded in the CG and all implants in this group were stable at the follow‐ups. At the 6‐month observation interval all the participating 20 patients were radiographically examined, an examination that was repeated at the 18‐month follow‐up. The analysis of the radiographs from the EG as well as from the CG disclosed that during the 12‐month observation period the mean change of bone support was about 0.1 mm. Further studies, designed as controlled multicenter ones, have to be performed before the results of this pilot study can be recommended for more general use.