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Bohne AS, Dunsche A, Kaeding M. Die Kombination des Brückenlappens nach Wilson mit A‐T‐Plastik bei ausgedehnten Lippenrotdefekten und Defekten der Lippenhaut. J Dtsch Dermatol Ges 2021; 19:147-150. [PMID: 33491902 DOI: 10.1111/ddg.14214_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ann-Sophie Bohne
- Klinik für Dermatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Anton Dunsche
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Städtisches Klinikum Karlsruhe
| | - Merit Kaeding
- Klinik für Dermatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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2
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Bohne AS, Dunsche A, Kaeding M. The combination of the Wilson bridge flap with A-T advancement flap for extensive red lip defects and defects of the skin of the lip. J Dtsch Dermatol Ges 2020; 19:147-150. [PMID: 32776687 DOI: 10.1111/ddg.14214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ann-Sophie Bohne
- Department of Dermatology, University Hospital Schleswig--Holstein, Campus Kiel, Kiel, Germany
| | - Anton Dunsche
- Department for Oral and Maxillofacial Surgery, Municipal Hospital Karlsruhe, Karlsruhe, Germany
| | - Merit Kaeding
- Department of Dermatology, University Hospital Schleswig--Holstein, Campus Kiel, Kiel, Germany
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3
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Affiliation(s)
- Sabine Tratzmiller
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Moltkestr. 120 (Gebäude V), 76133, Karlsruhe, Deutschland.
| | - Ulrich Schneider
- Pathologisches Institut, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - Anton Dunsche
- Klinik für Mund‑, Kiefer- und Gesichtschirurgie, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - Claus-Detlev Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Moltkestr. 120 (Gebäude V), 76133, Karlsruhe, Deutschland
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Thiele OC, Kreppel M, Dunsche A, Eckardt AM, Ehrenfeld M, Fleiner B, Gaßling V, Gehrke G, Gerressen M, Gosau M, Gröbe A, Haßfeld S, Heiland M, Hoffmeister B, Hölzle F, Klein C, Krüger M, Kübler AC, Kübler NR, Kuttenberger JJ, Landes C, Lauer G, Martini M, Merholz ET, Mischkowski RA, Al- Nawas B, Nkenke E, Piesold JU, Pradel W, Rasse M, Rachwalski M, Reich RH, Rothamel D, Rustemeyer J, Scheer M, Schliephake H, Schmelzeisen R, Schramm A, Schupp W, Spitzer WJ, Stocker E, Stoll C, Terheyden H, Voigt A, Wagner W, Weingart D, Werkmeister R, Wiltfang J, Ziegler CM, Zöller JE. Current concepts in cleft care: A multicenter analysis. J Craniomaxillofac Surg 2018. [DOI: 10.1016/j.jcms.2018.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ishorst N, Francheschelli P, Böhmer AC, Khan MFJ, Heilmann-Heimbach S, Fricker N, Little J, Steegers-Theunissen RPM, Peterlin B, Nowak S, Martini M, Kruse T, Dunsche A, Kreusch T, Gölz L, Aldhorae K, Halboub E, Reutter H, Mossey P, Nöthen MM, Rubini M, Ludwig KU, Knapp M, Mangold E. Nonsyndromic cleft palate: An association study at GWAS candidate loci in a multiethnic sample. Birth Defects Res 2018; 110:871-882. [PMID: 29498243 DOI: 10.1002/bdr2.1213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/19/2018] [Accepted: 02/07/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Nonsyndromic cleft palate only (nsCPO) is a common and multifactorial form of orofacial clefting. In contrast to successes achieved for the other common form of orofacial clefting, that is, nonsyndromic cleft lip with/without cleft palate (nsCL/P), genome wide association studies (GWAS) of nsCPO have identified only one genome wide significant locus. Aim of the present study was to investigate whether common variants contribute to nsCPO and, if so, to identify novel risk loci. METHODS We genotyped 33 SNPs at 27 candidate loci from 2 previously published nsCPO GWAS in an independent multiethnic sample. It included: (i) a family-based sample of European ancestry (n = 212); and (ii) two case/control samples of Central European (n = 94/339) and Arabian ancestry (n = 38/231), respectively. A separate association analysis was performed for each genotyped dataset, and meta-analyses were performed. RESULTS After association analysis and meta-analyses, none of the 33 SNPs showed genome-wide significance. Two variants showed nominally significant association in the imputed GWAS dataset and exhibited a further decrease in p-value in a European and an overall meta-analysis including imputed GWAS data, respectively (rs395572: PMetaEU = 3.16 × 10-4 ; rs6809420: PMetaAll = 2.80 × 10-4 ). CONCLUSION Our findings suggest that there is a limited contribution of common variants to nsCPO. However, the individual effect sizes might be too small for detection of further associations in the present sample sizes. Rare variants may play a more substantial role in nsCPO than in nsCL/P, for which GWAS of smaller sample sizes have identified genome-wide significant loci. Whole-exome/genome sequencing studies of nsCPO are now warranted.
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Affiliation(s)
- Nina Ishorst
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Paola Francheschelli
- Department of Biomedical and Specialty Surgical Sciences, Section of Medical Biochemistry, Molecular Biology and Genetics, University of Ferrara, Ferrara, Italy
| | - Anne C Böhmer
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Mohammad Faisal J Khan
- Department of Biomedical and Specialty Surgical Sciences, Section of Medical Biochemistry, Molecular Biology and Genetics, University of Ferrara, Ferrara, Italy
| | - Stefanie Heilmann-Heimbach
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Nadine Fricker
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Julian Little
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Regine P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Department of Pediatrics, Division Neonatology Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Borut Peterlin
- Department of Obstetrics & Gynecology, Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Stefanie Nowak
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Markus Martini
- Department of Oral and Maxillo-Facial-Plastic Surgery, University of Bonn, Bonn, Germany
| | - Teresa Kruse
- Department of Orthodontics, University of Cologne, Cologne, Germany
| | - Anton Dunsche
- Department of Oral and Maxillo-Facial Surgery, Clinics Karlsruhe, Karlsruhe, Germany
| | - Thomas Kreusch
- Department of Oral and Maxillofacial Surgery, Head and Neck Centre, Asklepios Klinik Nord-Heidberg, Hamburg, Germany
| | - Lina Gölz
- Department of Orthodontics, University of Bonn, Bonn, Germany
| | - Khalid Aldhorae
- Orthodontic Department, College of Dentistry, Thamar University, Thamar, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, Devision of Oral Medicine and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Heiko Reutter
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Neonatology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Peter Mossey
- Dental Hospital, University of Dundee, Dundee, United Kingdom
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Michele Rubini
- Department of Biomedical and Specialty Surgical Sciences, Section of Medical Biochemistry, Molecular Biology and Genetics, University of Ferrara, Ferrara, Italy
| | - Kerstin U Ludwig
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Michael Knapp
- Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
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6
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Stein S, Dunsche A, Gellrich NC, Härle F, Jonas I. One- or Two-Stage Palate Closure in Patients with Unilateral Cleft Lip and Palate: Comparing Cephalometric and Occlusal Outcomes. Cleft Palate Craniofac J 2017; 44:13-22. [PMID: 17214534 DOI: 10.1597/05-160] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To assess facial growth and dentoalveolar development in two groups of patients with complete unilateral cleft lip and palate. Primary surgical treatment differed in the timing of hard palate closure. Design: Forty-three patients with unilateral cleft lip and palate were examined. Twenty-two patients underwent early one-stage closure of the hard and soft palate cleft (mean age 23.0 ± 4.7 months); in 21 patients, the hard palate closure was delayed to 86.3 ± 39.2 months of age. Lateral cephalograms and dental casts were consecutively analyzed at four stages between 6 and 18 years of age. Results: Lateral cephalometric analysis revealed no significant intergroup differences in the sagittal and vertical craniofacial dimensions at any time. Dental cast analysis showed constriction of the upper anterior arch width at the ages of 6 and 10 years in patients with one-stage surgical palate closure, but a difference could no longer be verified at the ages of 15 and 18 years. Conclusions: The transverse distances in the upper jaw developed initially more positively in the group with delayed hard palate closure, but it became apparent later that the transverse deficiency after one-stage palate closure could be compensated for. When considering surgical treatment in general, the advantages of the delayed hard palate closure must be weighed against criteria favoring the early one-stage closure of the hard and soft palate.
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Affiliation(s)
- Silke Stein
- Department of Orthodontics, University of Freiburg, Germany.
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7
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Hoebel AK, Drichel D, van de Vorst M, Böhmer AC, Sivalingam S, Ishorst N, Klamt J, Gölz L, Alblas M, Maaser A, Keppler K, Zink AM, Dixon MJ, Dixon J, Hemprich A, Kruse T, Graf I, Dunsche A, Schmidt G, Daratsianos N, Nowak S, Aldhorae KA, Nöthen MM, Knapp M, Thiele H, Gilissen C, Reutter H, Hoischen A, Mangold E, Ludwig KU. Candidate Genes for Nonsyndromic Cleft Palate Detected by Exome Sequencing. J Dent Res 2017; 96:1314-1321. [PMID: 28767323 DOI: 10.1177/0022034517722761] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Nonsyndromic cleft palate only (nsCPO) is a facial malformation that has a livebirth prevalence of 1 in 2,500. Research suggests that the etiology of nsCPO is multifactorial, with a clear genetic component. To date, genome-wide association studies have identified only 1 conclusive common variant for nsCPO, that is, a missense variant in the gene grainyhead-like-3 ( GRHL3). Thus, the underlying genetic causes of nsCPO remain largely unknown. The present study aimed at identifying rare variants that might contribute to nsCPO risk, via whole-exome sequencing (WES), in multiply affected Central European nsCPO pedigrees. WES was performed in 2 affected first-degree relatives from each family. Variants shared between both individuals were analyzed for their potential deleterious nature and a low frequency in the general population. Genes carrying promising variants were annotated for 1) reported associations with facial development, 2) multiple occurrence of variants, and 3) expression in mouse embryonic palatal shelves. This strategy resulted in the identification of a set of 26 candidate genes that were resequenced in 132 independent nsCPO cases and 623 independent controls of 2 different ethnicities, using molecular inversion probes. No rare loss-of-function mutation was identified in either WES or resequencing step. However, we identified 2 or more missense variants predicted to be deleterious in each of 3 genes ( ACACB, PTPRS, MIB1) in individuals from independent families. In addition, the analyses identified a novel variant in GRHL3 in 1 patient and a variant in CREBBP in 2 siblings. Both genes underlie different syndromic forms of CPO. A plausible hypothesis is that the apparently nonsyndromic clefts in these 3 patients might represent hypomorphic forms of the respective syndromes. In summary, the present study identified rare variants that might contribute to nsCPO risk and suggests candidate genes for further investigation.
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Affiliation(s)
- A K Hoebel
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - D Drichel
- 3 German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,4 Cologne Center for Genomics, Department of Statistical Genetics and Bioinformatics, University of Cologne, Cologne, Germany
| | - M van de Vorst
- 5 Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A C Böhmer
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - S Sivalingam
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - N Ishorst
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - J Klamt
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - L Gölz
- 6 Department of Orthodontics, University of Bonn, Bonn, Germany
| | - M Alblas
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - A Maaser
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - K Keppler
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - A M Zink
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - M J Dixon
- 7 Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - J Dixon
- 7 Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - A Hemprich
- 8 Department of Oral and Maxillo-Facial Surgery, University of Leipzig, Leipzig, Germany
| | - T Kruse
- 9 Department of Orthodontics, University of Cologne, Cologne, Germany
| | - I Graf
- 9 Department of Orthodontics, University of Cologne, Cologne, Germany
| | - A Dunsche
- 10 Clinics Karlsruhe, Department of Oral and Maxillo-Facial Surgery, Karlsruhe, Germany
| | - G Schmidt
- 11 Department of Cleft Lip and Cleft Palate Surgery, Humboldt University of Berlin, Berlin, Germany
| | - N Daratsianos
- 6 Department of Orthodontics, University of Bonn, Bonn, Germany
| | - S Nowak
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - K A Aldhorae
- 12 Department of Orthodontics, College of Dentistry, Dhamar University, Dhamar, Yemen
| | - M M Nöthen
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - M Knapp
- 13 Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - H Thiele
- 14 Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - C Gilissen
- 5 Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Reutter
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,15 Department of Neonatology &Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - A Hoischen
- 5 Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.,16 Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,17 Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E Mangold
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - K U Ludwig
- 1 Institute of Human Genetics, University of Bonn, Bonn, Germany.,2 Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
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Thiele OC, Kreppel M, Bittermann G, Bonitz L, Desmedt M, Dittes C, Dörre A, Dunsche A, Eckert AW, Ehrenfeld M, Fleiner B, Frerich B, Gaggl A, Gerressen M, Gmelin L, Hammacher A, Haßfeld S, Heiland M, Hemprich A, Hidding J, Hölzle F, Howaldt HP, Iizuka T, Kater W, Klein C, Klein M, Köhnke RH, Kolk A, Kübler AC, Kübler NR, Kunkel M, Kuttenberger JJ, Kreusch T, Landes C, Lehner B, Mischkowski RA, Mokros S, Neff A, Nkenke E, Palm F, Paulus GW, Piesold JU, Rasse M, Rodemer H, Rothamel D, Rustemeyer J, Sader R, Scheer M, Scheffler B, Schippers C, Schliephake H, Schmelzeisen R, Schramm A, Spitzer WJ, Stoll C, Terheyden H, Weingart D, Wiltfang J, Wolff KD, Ziegler CM, Zöller JE. Moving the mandible in orthognathic surgery - A multicenter analysis. J Craniomaxillofac Surg 2016; 44:579-83. [PMID: 27017103 DOI: 10.1016/j.jcms.2016.01.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 01/11/2016] [Accepted: 01/27/2016] [Indexed: 11/30/2022] Open
Abstract
Orthognathic surgery has always been a classical focus of maxillofacial surgery. Since more than 100 years, various surgical techniques for mandibular repositioning have been developed and clinically tested. Since the establishment of plate and screw osteosynthesis, orthognathic surgery became more stable and safe. Nowadays, different surgical methods for mobilising the mandible are existing. This international multicenter analysis (n = 51 hospitals) is providing first evidence based data for the current use of different surgical methods. The dominating techniques were Obwegeser/dal Pont (61%) followed by Hunsuck/Epker (37%) and Perthes/Schlössmann (29%). The main osteosynthesis materials were plates (82%), bicortical screws (23.5%), or a combination of both (5.9%). 47% of all centers reported to use several surgical methods at the same time, depending on the anatomical problem and the surgeon's preference. This shows that different surgical methods seem to work as comparable, safe, and reliable procedures in everydays clinical practise. On this basis, further prospective studies could evaluate possible advantages for our patients.
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Affiliation(s)
- Oliver C Thiele
- Department of Oral, Maxillofacial and Facial Plastic Surgery (Head: Prof. R. A. Mischkowski), Ludwigshafen Hospital, Germany.
| | - Matthias Kreppel
- Department of Craniomaxillofacial and Plastic Surgery (Head: Prof. J.E. Zöller), University of Cologne, Germany
| | - Gido Bittermann
- Department of Oral and Maxillofacial Surgery (Head: Prof. R. Schmelzeisen), University Medical Center Freiburg, Germany
| | - Lars Bonitz
- Department of Craniomaxillofacial Surgery - Plastic Surgery (Head: Prof. S. Haßfeld), University Witten/Herdecke, Hospital Dortmund, Germany
| | - Maria Desmedt
- Fachklinik Hornheide, Department of Cranio-Maxillofacial Surgery (Head: Prof. M. Klein), Münster, Germany
| | - Carsten Dittes
- Department of Oral and Maxillofacial Surgery (Head: C. Dittes), Dietrich-Bonhoeffer-Hospital, Neubrandenburg, Germany
| | - Annegret Dörre
- Department of Oral and Maxillofacial Surgery (Head: A. Dörre), Chemnitz Hospital, Germany
| | - Anton Dunsche
- Department of Oral and Maxillofacial Surgery (Head: Prof. A. Dunsche), City Hospital Karlsruhe, Germany
| | - Alexander W Eckert
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery (Head: Prof. A. Eckert), Martin-Luther-University Halle-Wittenberg, Germany
| | - Michael Ehrenfeld
- Department of Oral and Maxillofacial Surgery (Head: Prof. M. Ehrenfeld), Ludwig Maximilians University of Munich, Germany
| | - Bernd Fleiner
- Oral and Maxillofacial Surgery (Head: B. Fleiner), Im Pferseepark, Augsburg, Germany
| | - Bernhard Frerich
- Department of Oral and Maxillofacial Surgery (Head: Prof. B. Frerich), Facial Plastic Surgery, Rostock University Medical Center, Germany
| | - Alexander Gaggl
- Department of Oral and Maxillofacial Surgery (Head: Prof. A. Gaggl), Paracelsus Medical University Salzburg, Austria
| | - Marcus Gerressen
- Department of Oral, Maxillofacial and Plastic Facial Surgery (Head: PD M. Gerressen), Heinrich-Braun Hospital Zwickau, Germany
| | - Leonore Gmelin
- Department of Oral, Maxillofacial and Facial Plastic Surgery (Head: Prof. R. A. Mischkowski), Ludwigshafen Hospital, Germany
| | - Andreas Hammacher
- Department of Oral and Maxillofacial Surgery (Head: Prof. A. Hammacher and H. Sieber), Malteser Hospital St. Johannes, Duisburg, Germany
| | - Stefan Haßfeld
- Department of Craniomaxillofacial Surgery - Plastic Surgery (Head: Prof. S. Haßfeld), University Witten/Herdecke, Hospital Dortmund, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery (Head: Prof. M. Heiland), University Medical Center Hamburg-Eppendorf, Germany
| | - Alexander Hemprich
- Department of Oral and Maxillofacial Plastic Surgery (Head: Prof. A. Hemprich), Leipzig University, Germany
| | - Johannes Hidding
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Hidding), Bethesda Hospital Mönchengladbach, Germany
| | - Frank Hölzle
- Department of Oral, Maxillofacial and Plastic Facial Surgery (Head: Prof. F. Hölzle), RWTH Aachen University Hospital, Germany
| | - Hans-Peter Howaldt
- Department for Cranio-Maxillofacial Surgery, Plastic Surgery (Head: Prof. H.P. Howaldt), University Hospital Giessen, Germany
| | - Tateyuki Iizuka
- Department of Cranio-Maxillofacial Surgery (Head: Prof. T. Iizuka), Inselspital, Bern University Hospital, Switzerland
| | - Wolfgang Kater
- Department of Oral and Maxillofacial Surgery (Head: W. Kater), Hochtaunus Hospital Bad Homburg, Germany
| | - Cornelius Klein
- Department of Oral and Maxillofacial Surgery (Head: Prof. C. Klein), Donauisar Hospital Deggendorf, Germany
| | - Martin Klein
- Fachklinik Hornheide, Department of Cranio-Maxillofacial Surgery (Head: Prof. M. Klein), Münster, Germany
| | - Robert H Köhnke
- Department of Oral and Maxillofacial Surgery (Head: Prof. M. Heiland), University Medical Center Hamburg-Eppendorf, Germany
| | - Andreas Kolk
- Department of Oral and Cranio-Maxillofacial Surgery (Head: Prof. K.D. Wolff), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Alexander C Kübler
- Department of Oral and Maxillofacial Plastic Surgery (Head: Prof. A.C. Kübler), University of Würzburg, Germany
| | - Norbert R Kübler
- Department of Cranio- and Maxillofacial Surgery (Head: Prof. N.R. Kübler), Heinrich-Heine-University Düsseldorf, Germany
| | - Martin Kunkel
- Department of Oral and Plastic Maxillofacial Surgery (Head: Prof. M. Kunkel), Ruhr-University Bochum, Germany
| | - Johannes J Kuttenberger
- Department of Oral and Maxillofacial Surgery (Head: PD J. Kuttenberger), Luzerner Kantonsspital, Switzerland
| | - Thomas Kreusch
- Department of Oral and Maxillofacial Plastic Surgery (Head: Prof. T. Kreusch), Asklepios Hospital Nord, Hamburg, Germany
| | - Constantin Landes
- Department of Oral and Maxillofacial Surgery (Head: Prof. C. Landes), Sana Hospital Offenbach, Germany
| | - Bernhard Lehner
- Department of Oral and Maxillofacial Surgery (Head: B. Lehner), Health Center St. Marien, Hospital Amberg, Germany
| | - Robert A Mischkowski
- Department of Oral, Maxillofacial and Facial Plastic Surgery (Head: Prof. R. A. Mischkowski), Ludwigshafen Hospital, Germany
| | - Steffen Mokros
- Department of Oral and Maxillofacial Surgery (Head: S. Mokros), Ameos Hospital Halberstadt, Germany
| | - Andreas Neff
- Department of Oral and Maxillofacial Surgery (Head: Prof. A. Neff), University of Marburg, University Hospital Giessen and Marburg, Campus Marburg, Germany
| | - Emeka Nkenke
- Department of Oral and Maxillofacial Surgery (Head: Prof. E. Nkenke), Medical University of Vienna, Austria
| | - Frank Palm
- Department of Oral and Maxillofacial Surgery (Head: Prof. F. Palm), Hospital Konstanz, Germany
| | - Gerhard W Paulus
- Department of Oral and Maxillofacial Surgery (Head: Prof. G.W. Paulus), Paracelsus Hospital Munich, Germany
| | - Jörn U Piesold
- Department of Oral and Maxillofacial Surgery (Head: PD J.U. Piesold), Helios Hospital Erfurt, Germany
| | - Michael Rasse
- Department for Cranio-, Maxillofacial and Oral Surgery (Head: Prof. M. Rasse), Medical University Innsbruck, Austria
| | - Herbert Rodemer
- Department of Oral and Maxillofacial Surgery (Head: H. Rodemer), Saarbrücken Hospital, Germany
| | - Daniel Rothamel
- Department of Craniomaxillofacial and Plastic Surgery (Head: Prof. J.E. Zöller), University of Cologne, Germany
| | - Jan Rustemeyer
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Rustemeyer), Plastic Operations, Hospital Bremen, Germany
| | - Robert Sader
- Department of Oral, Maxillofacial and Plastic Facial Surgery (Head: Prof. R. Sader), University Medical Centre Frankfurt/Main, Germany
| | - Martin Scheer
- Department of Oral and Maxillofacial Surgery (Head: PD M. Scheer), Hospital Minden, Germany
| | - Birgit Scheffler
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery (Head: Prof. A. Eckert), Martin-Luther-University Halle-Wittenberg, Germany
| | - Christian Schippers
- Department of Oral and Maxillofacial Surgery (Head: Prof. C. Schippers), Agaplesion Diakonie Hospital Rotenburg (Wümme), Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery (Head: Prof. H. Schliephake), George-Augusta-University, Göttingen, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery (Head: Prof. R. Schmelzeisen), University Medical Center Freiburg, Germany
| | - Alexander Schramm
- Department of Oral and Maxillofacial Surgery (Head: Prof. A. Schramm), Facial Plastic Surgery, Military Hospital of Ulm and University Hospital Ulm, Germany
| | - Wolfgang J Spitzer
- Department for Oral and Maxillofacial Surgery (Head: Prof. W. Spitzer), University Clinic of Saarland, Homburg/Saar, Germany
| | - Christian Stoll
- Department of Oral and Maxillofacial Surgery (Head: Prof. C. Stoll), Ruppiner Kliniken, Neuruppin, Germany
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery (Head: Prof. H. Terheyden), Red Cross Hospital, Kassel, Germany
| | - Dieter Weingart
- Department of Oral and Maxillofacial Surgery (Head: Prof. D. Weingart), Katharinen Hospital, Stuttgart, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Wiltfang), University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Klaus D Wolff
- Department of Oral and Cranio-Maxillofacial Surgery (Head: Prof. K.D. Wolff), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Christoph M Ziegler
- Department of Oral and Maxillofacial Surgery (Head: Prof. C. Ziegler), St Olavs University Hospital, Norwegian University for Science and Technology, Trondheim, Norway
| | - Joachim E Zöller
- Department of Craniomaxillofacial and Plastic Surgery (Head: Prof. J.E. Zöller), University of Cologne, Germany
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9
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Dunsche A, Fleiner B, Terheyden H, Hoffmeister B. Use of carbon dioxide laser in the therapy of benign oral soft-tissue lesions. Adv Otorhinolaryngol 2015; 49:136-9. [PMID: 7653348 DOI: 10.1159/000424357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Dunsche
- Department of Oral and Maxillofacial Surgery, University Hospital Kiel, Germany
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10
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Reutter H, Birnbaum S, Mende M, de Assis NA, Hoffmann P, Lacava AD, Herms S, Braumann B, Scheer M, Lauster C, Schmidt G, Schiefke F, Dunsche A, Martini M, Knapp M, Kramer FJ, Nöthen MM, Mangold E. Transforming growth factor-beta receptor type 1 (TGFBR1) is not associated with non-syndromic cleft lip with or without cleft palate in patients of Central European descent. Int J Pediatr Otorhinolaryngol 2009; 73:1334-8. [PMID: 19586667 DOI: 10.1016/j.ijporl.2009.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 05/31/2009] [Accepted: 06/08/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Transforming growth factor-beta (TGF-β) type 1 receptor (also known as activin receptor-like kinase 5, ALK5) is expressed in palatal tissue during embryogenesis. Experimental studies in transgenic mice with a genetic deletion of Alk5 showed that TGF-β type 1 receptor is required for upper lip and midline fusion of the hard and soft palate. In humans, association of TGF-β type 1 receptor gene (TGFBR1) and the development of non-syndromic cleft lip with or without cleft palate (NSCL/P) had been observed in a multiethnic sample of Chinese, Philippine, Indian and Turkish families. In order to re-evaluate the relevance of these findings, we carried out a family-based association study among 218 NSCL/P families of Central European descent. METHODS Genomic DNA was obtained from peripheral blood of 218 complete parent-offspring triads with NSCL/P. The sample comprised 14 patients with cleft lip only (CLO) and 204 patients with cleft lip and palate (CLP). Genotyping and transmission disequilibrium test (TDT) were performed on all 218 triads with a total of 17 tagging single-nucleotide polymorphisms (SNPs). We also performed testing for extended haplotypes and a log-linear model by Weinberg was used to screen parent-of-origin effects. Furthermore the use of estimates for the relative risks (RR) of Weinberg's model was obtained. RESULTS TDT analysis revealed no significant transmission distortion, neither at the level of individual markers nor at the level of haplotypes. Similarly negative results were obtained when we restricted our analysis to the subgroup of patients with CLP (n=204). Relative risk calculations (RR) of the children's and mothers' genotypes obtained negative results, after correction of p-values for multiple testing. Likewise application of Weinberg's log-linear model did not find any evidence for parent-of-origin effects in our sample. CONCLUSION Despite the ample evidence supporting the role of TGF-β type 1 receptor as a critically important and widespread morphogenetic regulator of craniofacial development in murine models, our results do not support TGFBR1 as major risk factor for NSCL/P in patients of Central European descent.
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MESH Headings
- Abnormalities, Multiple/epidemiology
- Abnormalities, Multiple/surgery
- Animals
- Animals, Newborn
- Cleft Lip/epidemiology
- Cleft Lip/genetics
- Cleft Lip/surgery
- Cleft Palate/epidemiology
- Cleft Palate/genetics
- Cleft Palate/surgery
- Cohort Studies
- Disease Models, Animal
- Europe/epidemiology
- Female
- Gene Expression Regulation, Developmental
- Genetic Predisposition to Disease/epidemiology
- Genetics, Population
- Humans
- Incidence
- Infant, Newborn
- Male
- Mice
- Mice, Transgenic
- Pedigree
- Protein Serine-Threonine Kinases/genetics
- Receptor, Transforming Growth Factor-beta Type I
- Receptors, Transforming Growth Factor beta/genetics
- Risk Assessment
- Species Specificity
- Syndrome
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Affiliation(s)
- Heiko Reutter
- Institute of Human Genetics, University of Bonn, Wilhelmstrasse 31, D-53111 Bonn, Germany.
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11
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Teschke M, Roldan J, Dunsche A, Fritzer E, Wiltfang J, Terheyden H. O.220 The vermillionectomy in the treatment of lower lip carcinoma. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71344-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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12
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Kovacs G, Maune S, Strege RJ, Holland D, Dunsche A. Visual acuity preservation by interdisciplinary approach and perioperative intensity modulated interstitial brachytherapy in intraorbital sarcomas of the child. Brachytherapy 2008. [DOI: 10.1016/j.brachy.2008.02.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Roldán JC, Teschke M, Fritzer E, Dunsche A, Härle F, Wiltfang J, Terheyden H. Reconstruction of the lower lip: rationale to preserve the aesthetic units of the face. Plast Reconstr Surg 2007; 120:1231-1239. [PMID: 17898595 DOI: 10.1097/01.prs.0000279147.73273.e9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The boundaries of the aesthetic units of the face are often crossed after lower lip cancer surgery. The aim of this study was to compare the aesthetic and functional outcome after use of different operative techniques based on the concept of the aesthetic units of the face. MATERIALS Sixty-three patients were evaluated after lower lip reconstruction. The aesthetic outcome was recorded by standard photography evaluating the disruption of the boundaries of the aesthetic units of the face, lip projection, and the resulting facial expression. The functional outcome consisted of the evaluation of mouth opening, pouting, and lips at rest for the evaluation of mouth continence. Three techniques were used: wedge excision, the Webster-Fries method, and the step technique. The step technique was combined with an Abbé or an Estlander flap in defects involving more than two-thirds of the lip. RESULTS In defects involving up to one-third of the lip, the aesthetic outcome was better for the step technique than for wedge excision (a statistical trend was observed, p = 0.088). In defects involving two-thirds of the lip, the aesthetic and functional outcome was better using the step technique than the Webster-Fries method (p = 0.002), because the boundaries of the aesthetic units are respected. In defects involving more than two-thirds of the lip, the result was better using the step technique combined with the Abbé flap. CONCLUSION The authors have shown that the step technique alone or combined with a flap of the opposite lip is a rational approach for preserving the aesthetic units of the face and its function.
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Affiliation(s)
- J Camilo Roldán
- Regensburg, Bonn, Karlsruhe, and Kiel, Germany From the Departments of Oral and Maxillofacial Surgery, University of Regensburg and University of Bonn, Department of Oral and Maxillofacial Surgery, Institute of Medical Informatics and Statistics, University Schleswig-Holstein, Campus Kiel, and Department of Oral and Maxillofacial Surgery, General Hospital Karlsruhe
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14
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Springer ING, Wiltfang J, Dunsche A, Lier GC, Bartsch M, Warnke PH, Barth EL, Terheyden H, Russo PAJ, Czech N, Acil Y. A new method of monitoring osteomyelitis. Int J Oral Maxillofac Surg 2007; 36:527-32. [PMID: 17418531 DOI: 10.1016/j.ijom.2007.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2006] [Revised: 12/12/2006] [Accepted: 01/04/2007] [Indexed: 11/27/2022]
Abstract
Chronic infections of bone such as osteomyelitis are frequent events, especially in immunocompromised or diabetic patients, and costly on a national level. Incorrect treatment or delayed diagnosis may lead to loss of the affected extremity or mandible. The aim of this study was to assess the possible value of urinary lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) concentrations in the monitoring of mandibular osteomyelitis. Patients were assigned to the following groups: group 1 (n=85), control; group 2a (n=38), patients with active disease; group 2b (n=25), patients of group 2a 6 months after successful treatment; group 2c (n=7), patients of group 2a with ongoing osteomyelitis 6 months after treatment. The range and upper limit of normal values (HP(max) and LP(max)) were determined in group 1. Levels of LP and HP were measured by high-performance liquid chromatography and fluorescence detection. There was a significant decrease (mean 45.43% for HP and 32.12% for LP) in samples of group 2b compared to 2a (P<0.001 for HP and LP). There was a significant increase in HP values in samples from group 2c compared to 2a (P=0.018). The urinary concentrations of HP and LP appear to act as a marker of disease activity, with a decrease reflecting treatment success and an increase or stable values indicating persistent disease. An inexpensive tool (US$5 per analysis) for the monitoring of osteomyelitis is described.
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Affiliation(s)
- I N G Springer
- Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str. 16, D-24105 Kiel, Germany.
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15
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Abstract
The purpose of this study was to investigate the expression of human beta-defensins (hBD-1, -2) in dental pulps by reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. The mRNA transcripts of human beta-defensin-1 and human beta-defensin-2 could be detected by performing RT-PCR. With immunohistochemical staining of pulp tissue using antisera to hBD-1 and -2 it was possible to demonstrate cytoplasmic expression in odontoblasts. The results demonstrate that not only oral keratinocytes at the epithelial surface but also odontoblasts express human beta-defensins. Thus odontoblasts take part in the innate immune system and human beta-defensins may play an important role in the innate host defense of human dental pulp.
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Affiliation(s)
- H Dommisch
- Department of Periodontology and Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.
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16
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Dommisch H, Açil Y, Dunsche A, Winter J, Jepsen S. Differential gene expression of human beta-defensins (hBD-1, -2, -3) in inflammatory gingival diseases. ACTA ACUST UNITED AC 2005; 20:186-90. [PMID: 15836521 DOI: 10.1111/j.1399-302x.2005.00211.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Antimicrobial peptides, like human beta-defensins, play an important role in the epithelial innate defense response. The aim of the present study was to investigate the quantitative expression of human beta-defensin-1, -2, and -3 in inflammatory gingival diseases. Gingival biopsies were obtained from patients with healthy gingiva (n = 10), patients with gingivitis (n = 10), and patients with periodontitis (n = 10). The clinical diagnosis was verified by histology. Gingival tissues were used for RNA extraction followed by reverse transcription. Gene expression was quantified by real-time polymerase chain reaction (normalization with GAP-DH). Comparing the tissues with different clinical stages of health and disease, no significant differences in mRNA expression were found for any of the beta-defensins studied. Similar levels of expression were found in healthy gingiva, whereas in gingivitis samples there was a significantly higher expression of hBD-2 compared to hBD-1 (P = 0.004) and hBD-3 (P = 0.016). Likewise, in periodontitis samples, hBD-2 expression was significantly higher than hBD-1 (P = 0.016); however, hBD-2 expression was comparable to hBD-3. In conclusion, the results of the present study showed a differential expression of human beta-defensins (hBD-1, -2, -3) in tissues with inflammatory gingival disease.
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Affiliation(s)
- H Dommisch
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.
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17
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Springer ING, Terheyden H, Suhr MAA, Warnke P, Dunsche A, Tiemann M, Açil Y. Follow-up of collagen crosslink excretion in patients with oral squamous cell carcinoma and analysis of tissue samples. Br J Cancer 2003; 89:1722-8. [PMID: 14583776 PMCID: PMC2394412 DOI: 10.1038/sj.bjc.6601325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The presence of an oral squamous cell carcinoma (OSCC) may be associated with increased urinary excretion of the markers of collagen degradation, hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP). We investigated the possibility of these markers predicting the presence of active disease. Patients from a current study on HP and LP were included as follows: Group 1a (OSCC with confirmed mandibular bony infiltration, n=12), group 1b (group 1a patients >6 months after successful treatment), group 2a (OSCC without evidence of mandibular bone infiltration, n=8), group 2b (group 2a patients >6 months after successful treatment), group 3a (recurrent OSCC, n=8), group 3b (group 3a patients >6 weeks later, symptoms unchanged) and group 4 (control group, n=74). Tissue samples from tumour tissue and adjacent healthy mucosa were additionally investigated for HP and LP concentrations (n=8). The decrease in the urinary concentrations of HP and LP was statistically significant between groups 1a and 1b (P<0.001 for HP and LP), but not between groups 2a and 2b (P=0.07 for HP and LP), while values in groups 1b and 2b were within the normal range. When comparing groups 3a and 3b, a significant increase was observed for LP (P=0.050), but not HP (P=0.208). In conclusion, successful treatment of OSCC with bony involvement may be associated with a reduction of urinary HP and LP, whereas ongoing disease may result in an increase of LP. HP and LP may both be useful markers of tumour progression in patients with OSCC.
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Affiliation(s)
- I N G Springer
- Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Hellerstr. 16, D-24105 Kiel, Germany.
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18
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Abstract
BACKGROUND Unicystic ameloblastomas (UAs) and dentigerous cysts (DCs) have an identical clinical and radiographic appearance. Some subtypes of UAs have a better prognosis than solid or multicystic ameloblastomas, and simple enucleation is the adequate treatment. The present study was designed to test the hypothesis that UAs with small islands of ameloblastomatous epithelium may be misdiagnosed as a DC or keratocyst if no more than two histologic sections are examined. METHODS A total of 101 resection specimens from 22 women and 73 men (mean age: 46.5 years) were selected, all showing the clinical and radiographic features of a DC. Only cysts with a minimum diameter of 15 mm in the panoramic X-ray were considered for the present investigation. The histopathologic diagnosis had been routinely established by examining two sections. For our study, the specimens were investigated by step sections at 50 microm and by staining of 5 microm thin sections with hematoxylin and eosin (H&E) at 1 mm levels. An average of 15 slides were evaluated per case. RESULTS Microscopic examination of the step sections did not reveal ameloblastomatous epithelium in the cyst lining epithelium of the 101 cases. Thus, every primary diagnosis of a dentigerous cyst was confirmed. In four cases, additional rather large odentogenic cell nests were detected with palisading of basaloid cells, while there was a lack of other signs of ameloblastic differentiation. All lesions were completely resected, and no additional treatment was performed. CONCLUSIONS Step sectioning of larger DCs may reveal associated odontogenic cell nests in some cases but does not lead to the detection of formerly missed ameloblastic cells. Thus, unicystic ameloblastomas are not misdiagnosed if only two slides are prepared for routine diagnosis of DCs.
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Affiliation(s)
- Anton Dunsche
- Department of Oral and Maxillofacial Surgery, University of Kiel, D-24105 Kiel, Germany
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19
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Abstract
Lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) are collagen crosslink residues of which the urinary concentration reflects the level of connective-tissue turnover. HP is ubiquitous in tissue, whereas LP is specific for bone. The purpose of this investigation was to assess the sensitivity and specificity of an increased urinary concentration of both HP and LP in indicating infiltration of mandibular bone by an oral squamous cell carcinoma (OSCC) or recurrence of the disease after successful therapy. We investigated the history and urine levels in 116 adult patients, who were divided into the following groups. Group 1: patients with OSCC with bone infiltration (n=17); group 2: patients with confirmed OSCC (n=12) without evidence of bone infiltration; group 3: patients with recurrence of an OSCC (n=13); group 4: patients without clinical evidence of disease (n=74). The range and upper limit of normal values (HP(max) and LP(max)) were measured from the normal controls in group 4. Levels of LP and HP were measured by HPLC and fluorescence detection. There was a significant difference in the average urinary levels of LP and HP between groups 1-4 (P<0.001). The presence of mandibular bone infiltration could be detected with a sensitivity and specificity of 100% when comparing groups 1 and 2. Presence of tumour tissue could be detected with a sensitivity of 90%. In conclusion, a normal LP concentration in patients with an OSCC strongly suggests that bone invasion by the disease has not taken place. If both urinary HP and LP are elevated, disease recurrence is highly likely.
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Affiliation(s)
- I N G Springer
- Department of Oral and Maxillofacial Surgery, University of Kiel, Germany.
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20
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Abstract
BACKGROUND In 97% of all patients with oral lichenoid reactions (OLR) associated with dental amalgam a removal of the fillings leads to a decline of the lesions, as a minimum. OBJECTIVES The aim of this study was to determine if contact allergic or local toxic effects or both may contribute to OLR using an animal model with mercury-sensitive and non-sensitive rats. METHODS Twenty Brown Norway rats, which have a genetic predisposition for an autoimmune syndrome after exposure to mercury and 20 Lewis rats, not mercury sensitive, were treated as follows: 10 animals of each group were sensitized with a low dose of mercuric chloride. Half of all animals received local exposure of the right buccal mucosa to amalgam (left: control), the others to amalgam alloy free of mercury. All rats were patch tested with an amalgam series. RESULTS After 20 days of exposure 96% of all animals showed white mucosal lesions restricted to the contact zone of the alloy on the treated side, but only up to 25% had a positive patch test reaction to amalgam or inorganic mercury (INM). The lesions showed no relation to species, alloy, sensitization or patch test reaction. CONCLUSIONS While allergic mechanisms may contribute to mucosal contact lesions in Brown Norway rats, this is less probable in Lewis rats. Mercury in general appears to be irrelevant in the development of ORL in this study. If this holds true for humans as well, patch testing with an amalgam series may be helpful in a minor fraction of all patients with OLR.
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Affiliation(s)
- A Dunsche
- Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str. 16, D-24105 Kiel, Germany
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21
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Dunsche A, Kästel I, Terheyden H, Springer ING, Christophers E, Brasch J. Oral lichenoid reactions associated with amalgam: improvement after amalgam removal. Br J Dermatol 2003; 148:70-6. [PMID: 12534597 DOI: 10.1046/j.1365-2133.2003.04936.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. OBJECTIVES To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. METHODS In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. RESULTS Eleven patients with OLR (8.2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27.7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97.1%), of whom 31 (29.5%) were cured completely. Of 357 lesions, 213 (59.7%) cleared after removal of amalgam, whereas 65 (18.2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6.9%) showed an improvement (P < 0.05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0.05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0.05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0.05). After an initial cure following amalgam removal, 13 lesions (3.6%) in eight patients (7.6%) recurred after a mean of 14.6 months. CONCLUSIONS Of all patients with OLR associated with dental amalgam fillings, 97.1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.
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Affiliation(s)
- A Dunsche
- Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str. 16, Germany.
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22
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Terheyden H, Müller A, Dunsche A, Härle F. [Comparison of secondary and tertiary cleft jaw osteoplasty. 20 year analysis]. Mund Kiefer Gesichtschir 2002; 6:134-9. [PMID: 12143123 DOI: 10.1007/s10006-002-0375-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of secondary cleft osteoplasty is to provide alveolar bone for the complete eruption of the canine and sometimes of the lateral incisor to the occlusal plane and, thus, preservation of a continuous dental arch. This concept has not changed during the last 20 years in our clinic, providing an opportunity for an analysis of a homogeneous group of cleft patients. This group of patients was compared with a similar group of tertiary osteoplasties, performed during the same time span in our clinic. MATERIAL AND METHODS From 1980 to 1999, 376 cleft osteoplasties were performed in 295 patients, 264 of whom (136 secondary and 128 tertiary osteoplasties) were available for continuous prospective follow-up. Special emphasis was put on preoperative orthodontic treatment with removal of crossbites, oral hygiene, and meticulous disinfection. Autogenous cancellous iliac bone was used exclusively. RESULTS The postoperative height of the interalveolar septum (Abyholm classes) was I (1/1, 69.4%/45.8%), II (> 3/4, 28.2%/41.7%), III (< 3/4, 2.4%/10%), and IV (complete failure, 0%/2.5%) (secondary vs tertiary). Complications were infections (6.6% vs 14%), fistulae (0.7% vs 5.8%), and external root resorption (0% vs 7.4%). The lateral incisor was aligned into the arch in 55.5% vs 29.8% and the canine was in the correct position in 100% vs 83.6% (secondary vs tertiary). CONCLUSION Secondary cleft osteoplasty was more advantageous than tertiary due to better preservation of the neighboring teeth.
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Affiliation(s)
- H Terheyden
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Kiel.
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Abstract
The purpose of this study was to investigate the expression of human beta-defensins (hBD), especially of the recently discovered hBD-3, in oral tissues by reverse-transcription polymerase chain reaction (RT-PCR). Primary oral keratinocytes (n = 3) and fibroblasts (n = 3), 64 non-inflamed and 40 inflamed oral tissue samples, and 10 samples of salivary glands, were examined. The transcripts for hBD-3 (61/64), as well as for hBD-1 (64/64) and hBD-2 (54/64), were found to be widely expressed in non-inflamed oral tissues. In contrast, only 23, 22 and 24 of the 40 inflamed tissues showed detectable hBD-1, -2 and -3 transcripts, respectively. In salivary glands, mRNA expression was constitutive for hBD-1, frequent for hBD-2 (9/10), and infrequent for hBD-3 (4/10). Oral keratinocytes, but not fibroblasts, contained transcripts for all beta-defensins, suggesting that the novel hBD-3 is also produced in the epithelial compartment of oral tissues. The results indicate an important role for the novel hBD-3, as well as for hBD-1 and hBD-2, in the innate oral epithelial host defense.
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Affiliation(s)
- Anton Dunsche
- Department of Oral and Maxillofacial Surgery, University Hospital Kiel, Germany.
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Bolouri S, Podzich B, Terheyden H, Kolbe G, Dunsche A. [Development of speech and facial skull growth after primary velopharyngoplasty in lip-jaw-palate clefts]. Mund Kiefer Gesichtschir 2002; 6:45-8. [PMID: 11974545 DOI: 10.1007/s10006-001-0353-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND A two-armed, prospective, randomized study was performed to evaluate the influence of primary velopharyngoplasty on speech and facial growth in patients with cleft lip and palate. PATIENTS AND METHODS Forty-two patients born between 1978 and 1982 were included. All patients were treated with an intravelar veloplasty, and 21 patients simultaneously with a velopharyngoplasty according to Sanvenero-Rosselli. The patients were examined at the age of 5, 10, 15, and 18 years according to the recommendations of the research group of the German Association of Craniomaxillofacial Surgery for minimal documentation. RESULTS Patients treated with primary velopharyngoplasty showed a higher deficit in transversal growth of the maxilla of 0.6 mm in the molar region in adolescence in comparison to the control group. The sagittal growth of the maxilla was reduced at 2.6 degrees in the SNA angle. A statistically significant decrease in growth of the maxilla caused by primary velopharyngoplasty was not detectable (p > 0.05). The incidence of rhinophonia and dyslalia did not differ significantly. Primary velopharyngoplasty did not lead to speech improvement either in childhood or in adolescence. CONCLUSION With regard to a potential decrease in growth of the maxilla and the disadvantages of a hindered nasal respiration, a primary velopharyngoplasty therefore does not seem to be indicated.
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Affiliation(s)
- S Bolouri
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Kiel, Arnold-Heller-Strasse 16, 24105 Kiel.
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Moehrle M, Lischner S, Dunsche A, Breuninger H, Hauschild A. Cerebriform giant melanocytic nevus of the scalp: report of two cases with different surgical approaches. Dermatol Surg 2002; 28:75-9. [PMID: 11991276 DOI: 10.1046/j.1524-4725.2002.01105.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cerebriform giant melanocytic nevus of the scalp is an extremely rare malformation. Clinical appearance with maceration and fetor within the crypts and the risk of malignant transformation may require surgical therapy. We report two cases with different methods of surgical management. A 27-year-old woman noticed a swelling of the parietal scalp that developed over a period of 4 years into a gyrus-like tumor measuring 12 cm x 18 cm. The crypts between the gyri could not be inspected. Serial excisions under subcutaneous infusion anesthesia were performed to reduce the size of the nevus and to flatten the surface of the scalp. The second patient, a 26-year-old man, demonstrated a giant 10 cm x 10 cm cerebriform nevus on the occiput. The nevus also contained areas of fetid maceration. After implanting a tissue expander under general anesthesia the nevus was excised. The defect was closed using a rotation flap.
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Affiliation(s)
- Matthias Moehrle
- Department of Dermatology, Eberhard-Karls-University, Tuebingen, Germany.
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Terheyden H, Warnke P, Dunsche A, Jepsen S, Brenner W, Palmie S, Toth C, Rueger DR. Mandibular reconstruction with prefabricated vascularized bone grafts using recombinant human osteogenic protein-1: an experimental study in miniature pigs. Part II: transplantation. Int J Oral Maxillofac Surg 2001; 30:469-78. [PMID: 11829227 DOI: 10.1054/ijom.2000.0008] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Osteogenic Protein-1 (rhOP-1), also called bone morphogenetic protein-7 (BMP-7), is osteoinductive. The aim of this study was to present a new surgical technique: the prefabrication of a vascularized bone graft using rhOP-1 and its microsurgical transplantation. During 6 weeks, osteomuscular grafts were prefabricated in the latissimus dorsi muscle of five adult minipigs. Six hundred micrograms rhOP-1 on a carrier of xenogenic bone mineral in block form were used. The grafts were transplanted into defects of the mandibular angles performing a microsurgical anastomosis and using miniplates for fixation. Identical defects of the contralateral side were treated by direct application of 600 microg rhOP-1 and xenogenic bone mineral. A polychrome sequential labelling was applied. After transplantation the bone stayed viable, demonstrated by continuous apposition of fluorochromes (non-decalcified histologic sections) and bone scintigraphy. The reconstructive result was significantly superior in the prefabrication technique, assessed by histology and computerized tomography (CT). In conclusion, the method has a potential to become a clinical alternative for conventional vascularized bone grafts.
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Affiliation(s)
- H Terheyden
- Department of Oral and Maxillofacial Surgery, University of Kiel, Germany.
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Lischner S, Dunsche A, Hauschild A. [Congenital cerebriform nevus cell nevus on the occiput. Removal after tissue expander implantation]. Hautarzt 2001; 52:952-5. [PMID: 11715392 DOI: 10.1007/s001050170006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 26 year old man presented with a giant cerebriform nevus on the occiput. Clinical appearance of the nevus, maceration within the folding and risk of malignancy prompted us to perform a complete excision. The scalp defect was closed with a rotation flap following an implantation of a tissue expander.
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Affiliation(s)
- S Lischner
- Klinik für Dermatologie, Venerologie und Allergologie der Christian-Albrechts-Universität zu Kiel
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Roldán JC, Terheyden H, Dunsche A, Kampen WU, Schroeder JO. Acne with chronic recurrent multifocal osteomyelitis involving the mandible as part of the SAPHO syndrome: case report. Br J Oral Maxillofac Surg 2001; 39:141-4. [PMID: 11286450 DOI: 10.1054/bjom.2000.0591] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
For 12 years, a 26-year-old man had acne conglobata and a non-suppurative diffuse sclerosing osteomyelitis of the mandible as part of a chronic recurrent multifocal osteomyelitis of the sternum, the pelvic bones, and the femoral head, and aseptic arthritis of the knee, the fibulotalar, and the sternoclavicular joints. This fulfills the formal criteria of the SAPHO syndrome. Repeated surgical and antibiotic treatment combined with hyperbaric oxygen caused partial improvement. Complete relief and partial disappearance of the scintigraphic lesions was achieved with long-term corticosteroids, non-steroidal anti-inflammatory drugs, minocycline, and isotretinoin.
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Affiliation(s)
- J C Roldán
- Department of Oral and Maxillofacial Surgery, Christian-Albrechts-Universität, Kiel, Germany.
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Abstract
Antimicrobial peptides and proteins are an important part of the innate host defense. In the present study, the expression profile of three human alpha-defensins, of two human beta-defensins (hBD) and of phospholipase A-2 (PLA-2) and lysozyme was determined by reverse transcription-polymerase chain reaction (RT-PCR) in 56 non-inflamed and 18 inflamed oral tissue samples and primary oral keratinocytes and fibroblasts. The transcripts for hBD-1 and -2 as well as for PLA-2 and lysozyme were found to be widely expressed. In the group of the alpha-defensins, the message for the human neutrophil peptide-1 (HNP-1) was frequently detected, whereas an expression of human Paneth's cell defensin-5 (HD-5) was identified in only a minority of samples. Transcripts for HD-6 were not detectable in any sample. Oral keratinocytes but not fibroblasts contained transcripts for the beta-defensins, suggesting that these defensins are produced in the epithelial compartment. In contrast, mRNA expression of neutrophil-derived HNP-1 and PLA-2 was not observed in any of these cells. These results suggest an important role for hBD-1 and hBD-2 in the innate oral epithelial host defense.
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Affiliation(s)
- A Dunsche
- Department of Oral and Maxillofacial Surgery, University of Kiel, Germany
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Abstract
In this study, we investigated the growth and extracellular matrix synthesis of human osteoblast-like cells on highly porous natural bone mineral. Human bone cells were isolated from trabecular bone during routine iliac crest biopsies. Under conventional culture conditions, trabecular bone cells were able to assume the organization of a three-dimensional structure on a porous natural bone mineral (Bio-Oss(R) Block). Scanning electron microscopy examination after 6 weeks revealed multiple cell layers on the trabecular block. Transmission electron microscopy examination after 6 weeks revealed the accumulation of mature collagen fibrils in the intracellular and extracellular spaces, and showed multilayered, rough endoplasmic reticulum as well as mitochondria-rich cells surrounded by dense extracellular matrix. These morphological observations suggest that the cell layer may resemble the natural three-dimensional structure. Biochemical analysis revealed that the hydroxylysylpyridinoline, lysylpyridinoline, and hydroxyproline content of the cell layer increased in a time-dependent manner, whereas in monolayer culture without natural bone mineral, no measurable amounts of hydroxylysylpyridinoline or lysylpyridinoline, and a barely measurable amount of hydroxyproline, were noted. Mature collagen extracted by ethylenediaminetetraacetic acid-demineralization from the cell layer on natural bone mineral showed an identical electrophoretic pattern to that observed in human bone, as evaluated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. The present study demonstrated an excellent biocompatibility of the highly porous natural bone mineral in a three-dimensional bone cell culture system, and thus its potential for tissue-engineered growth of human bone.
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Affiliation(s)
- Y Açil
- Department for Oral and Maxillofacial Surgery, Kiel University, Arnold-Heller-Strasse 16, 24105 Kiel, Germany.
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Abstract
UNLABELLED According to the WHO collaborating centre precancerous lesions and precancerous conditions have to be distinguished. Precancer: BACKGROUND Erythroplakia is the most dangerous precancerous lesion. It is rare, but may often remain undetected. It will transform into cancer within five years and therefore, has to be excised in every case. Leukoplakias show malignant transformation in 3-45% of the cases. In spite of modern molecular biological and immunohistochemical techniques the clinical appearance and the histological grading of the dysplasia are still most important prognostic factors. Until 1992 every lesion showing signs of moderate and severe dysplasia was excised in our department. Despite this treatment strategy 6.2% of the leukoplakias (n = 161) transformed into cancer. Therefore, we recommend to remove every lesion which does not disappear after eliminating the etiological factors. METHODS Since 1992 168 leukoplakias were completely removed using the CO2 Laser and underwent histological examination. RESULTS In 3% of these cases a carcinoma was detected in the leukoplakia; 5% of the lesions recurred. Precancerous condition: The most important precancerous condition, the oral lichen planus is treated in cases of erosive lesions only or if the patient is suffering from the symptoms. Malignant transformation is seen in 1.5% of the patients within 10 to 15 years. Histologically the oral lichen planus does not differ from the oral lichenoid reactions, lesions in contact with amalgam restorations mostly. In these cases a causative treatment with replacement of the amalgam is recommended.
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Affiliation(s)
- A Dunsche
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Christian-Albrechts-Universität zu Kiel
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Dunsche A. [The anatomically difficult maxilla--preprosthetic surgery and implantology. The working group of maxillofacial surgery of the German Society for Dentistry held its 46th congress jointly with the German Society for Implantology from 25 to 27 May 1995 in Bad Homburg]. Schweiz Monatsschr Zahnmed 1995; 105:1597-1599. [PMID: 8553044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Dunsche A. [3 symposia on minimally invasive surgery. A report on the 12th International Congress for Oral and Maxillofacial Surgery of 29 June to 2 July 1995 in Budapest]. Schweiz Monatsschr Zahnmed 1995; 105:1501-1503. [PMID: 7494987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Hoffmeister B, Fleiner B, Dunsche A. [Significance of vascularization of jejunal transplants in secondary reconstruction of the mandible]. Fortschr Kiefer Gesichtschir 1994; 39:111-114. [PMID: 8088633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
There is a difference in the vascular architecture of myocutaneous flaps and jejunal free flaps both available to replace resected mucosal tissue of the oral cavity after surgical treatment of oral cancer. The question in whether the mobilization of jejunal free flaps is possible without respect to the anastomized vessels in particular in secondary reconstruction procedures to achieve a bony continuity of the mandible. From 1985-1992 22 patients were operated on using microsurgically anastomized jejunal free flaps. In 7 cases a secondary mandibular reconstruction by means of microsurgically anastomized iliac crest grafts was performed. In respect of our results we recommend in cases of secondary mandibular reconstruction with mobilisation of the jejunal flap. 1. preoperative digital subtraction angiography, 2. temporary clamp of anastomized vessels with observation of the perfusion of the jejunal flap, 3. intraoperative doppler-sonography. These techniques allow a save evaluation of the vessels of the donor site prior to microvascular anastomoses for secondary bony reconstruction of the mandible.
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Affiliation(s)
- B Hoffmeister
- Klinik für Mund-, Kiefer- und Gesichtschirurgie im Klinikum der Christian-Albrechts-Universität Kiel
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