Discomfort/pain due to periodontal and peri-implant probing with/without platform switching.

OBJECTIVE: To compare discomfort/pain following periodontal probing around teeth and peri-implant probing around implants with or without platform switching. METHODS: Two dentists recruited and examined 65 patients, each of them exhibiting a dental implant with a contralateral tooth. Only two types of implants were included: one with and one without platform switching. Periodontal and peri-implant probing depths (PPD) and probing attachment level (PAL) were assessed. Whether implant or tooth was measured first was randomly assigned. Immediately after probing, patients scored discomfort/pain using a visual analogue scale (VAS). The emergence profiles of implant crowns were assessed as angles between interproximal surfaces on radiographs. RESULTS: Sixty-five patients (age 69; 63/76 years [median; lower/upper quartile]; 38 females, 11 smokers) were examined. With the exception of mean PPD and PAL (p < .05) clinical parameters (PPD, PAL, bleeding on probing, suppuration) were well balanced between implants and teeth. Peri-implant probing (VAS: 10; 0.75/16.25) caused significantly (p < .001) more discomfort/pain than periodontal probing (4; 0/10). Logistic regression analysis identified a larger difference between discomfort/pain for peri-implant and periodontal probing in the maxilla than the mandible (p = .003). Comparing discomfort/pain between implants maxilla (p = .006) and emergence profile (p = .015) were associated with discomfort/pain. Type of implant (with/without platform switching) had no significant effect on discomfort/pain. CONCLUSIONS: Peri-implant probing caused significantly more discomfort/pain than periodontal probing. Implant design with/without platform switching failed to have a significant effect on discomfort/pain.

Discomfort/pain due to periodontal and peri-implant probing: Implant type and age.

AIM: There is evidence that patients experience more discomfort/pain after peri-implant probing than periodontal probing. However, there are several plausible factors to additionally influence this observation: e.g., implant type, age, smoking. Thus, this study was designed to compare discomfort/pain after periodontal and peri-implant probing in different implant types. METHODS: Two dentists recruited and examined 80 patients, each of them exhibiting a dental implant with a contralateral natural tooth. Only two types of implants were included. Periodontal and peri-implant probing depths (PPD) and probing attachment level (PAL) were assessed. Whether implant or tooth were measured first was randomly assigned. Immediately after probing patients scored discomfort/pain using a visual analogue scale (VAS). RESULTS: Eighty patients (median; lower/upper quartile: age 57; 47.5/65.5 years; 40 females, 11 smokers) were examined. With the exception of PPD and PAL at the deepest site as well as mean PPD (p < .05) clinical parameters (PAL, bleeding on probing, suppuration) were well balanced between implants and teeth. Peri-implant probing (VAS: 9.0; 5.0/17.0) caused significantly (p = .038) more discomfort/pain than periodontal probing (5.5; 2.0/13.5). This was confirmed by repeated measures analysis of variance adjusting for several factors (p = .011). CONCLUSIONS: Peri-implant probing caused significantly more discomfort/pain than periodontal probing.

Anatomical transosseous fixation of the deep and superficial fibers of the radioulnar ligaments.

INTRODUCTION: The triangular fibrocartilage complex is in conjunction with the interosseous membrane the most important stabilizer of the distal radioulnar joint. Lesions of the triangular fibrocartilage complex may cause instability of the distal radioulnar joint with serious consequences. Therefore, the goal is to reconstruct and provide stability to prevent further harm. SURGICAL TECHNIQUE: Based on the anatomical configuration of the radioulnar ligaments, we present a technique which addresses both the deep and the superficial fibers of the radioulnar ligaments. This surgical procedure can be performed either openly or arthroscopically assisted. Two osseous 2-mm tunnels starting from the ulnar neck to the foveal surface are created. A nonabsorbable suture is passed through the tunnels and the triangular fibrocartilage using a 20-gauge venipuncture needle in order to attach the deep fibers. Then a third osseous tunnel starting from the lateral base of the styloid process to the medial aspect is created. The suture is passed through this tunnel and through the triangular fibrocartilage and around the styloid process palmarily using the same needle as before in order to anchor the superficial fibers anatomically. After reducing the ulna head the sutures are tightened. CONCLUSION: This technique is quite simple and addresses the anatomical configuration of the radioulnar ligaments.

Functionality of middle-aged women after resection-interposition arthroplasty of the trapeziometacarpal joint in comparison to a healthy control group.

INTRODUCTION: Trapeziometacarpal joint osteoarthritis is a very common degenerative joint disease which affects especially women between their fifth and sixth decade of life. To determine the final pinch, grip and functional outcome after trapeziometacarpal arthroplasty and to compare to non-arthritic controls, we hypothesized that patients after the former surgery are expected to have lower grip and pinch strength and a higher DASH score. MATERIALS AND METHODS: 44 women (range 50-65 years of age; median 57 years of age) were examined after resection-interposition arthroplasty because of trapeziometacarpal joint osteoarthritis Eaton-Littler stage 3 and 4 with a minimum follow-up time of 12 months (range 12-99 months; median 47 months) using DASH questionnaire and grip and pinch strength evaluation. The control group consisted of 107 healthy age-matched controls (range 50-64 years of age; median 54 years of age). Differences between both groups were statistically analysed using analysis of covariance. RESULTS: A significant loss of pinch strength and a significant higher DASH score were detected for the patient group in comparison to the controls, whereas grip strength did not differ significantly. CONCLUSIONS: A loss of pinch strength in conjunction with a higher DASH score was detected. The expected loss of pinch strength in conjunction with a reduced physical functionality should be discussed preoperatively with the patient to meet the expectations and to offer the best suitable treatment option.

Normative data on wrist function.

PURPOSE: In clinical day-to-day life, grip strength, key pinch, and range of motion (ROM) serve to objectively evaluate treatment outcomes on wrist interventions. The goals of this study were to generate normative values of wrist function including the parameters of grip strength, key pinch, wrist ROM, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores in a healthy, working population, and to investigate the influence of age, sex, body weight and height, handedness, and work strain. METHODS: We clinically examined 750 volunteer working subjects (363 women and 387 men, all white). We divided subjects into 2 groups depending on whether their labor involved high or low manual strain. We recorded participants' height, weight, grip strength, pinch strength, and wrist ROM. Each participant filled out a DASH questionnaire. RESULTS: Grip strength and pinch strength showed a maximum at between 30 and 49 years of age. In men, body mass index, body height, and weight all correlated with grip strength and pinch grip. Whereas women exhibited greater grip strength on the right side, men showed nonsignificant greater grip strength on the left side. Wrist ROM was greatest for ages ranging between 18 and 29 years. The average DASH value for all male subjects was significantly less than that of female subjects. In a healthy working population, the DASH score increased yearly by an average of 0.2 points in men and 0.3 points in women. CONCLUSIONS: This study showed that in a healthy working population, people 30 to 49 years of age had the highest grip strength and pinch strength. Age positively correlated with the DASH score and inversely related to wrist ROM. Persons employed in jobs with high manual strain presented with lower wrist ROM and higher DASH scores. CLINICAL RELEVANCE: These data help to objectively evaluate wrist function and the effectiveness of therapeutic interventions.

Predicting grip strength and key pinch using anthropometric data, DASH questionnaire and wrist range of motion.

PURPOSE: The objective of this study was to examine the influence of anthropometric data, occupational manual strain, DASH (disability of arm, shoulder and hand) score and range of motion (ROM) on grip strength and key pinch. An additional goal was to develop models that enable the prediction of hand strength using the aforementioned parameters. METHODS: Normative data generated from a healthy working population (n = 750) served as basis for the statistical analysis. Prediction models for hand strength were developed using multivariate regression analysis. RESULTS: Gender, body weight and height, BMI and extension ROM correlate positively, age and DASH score, however, correlate negatively with grip strength and key pinch. Occupational manual strain has no influence on hand strength. The predictive power of the developed models was 68.4 % for grip strength and 57.1 % for key pinch. CONCLUSIONS: The developed models enable the prediction of hand strength using easily obtainable data points. The models will have application in clinical practice, physiological studies, medical evidence and rehab decisions.