Proposed requirements for a European Doctorate in Dentistry: a discussion document prepared by a special interest group under the auspices of the Association for Dental Education in Europe.

In the Bologna process a third cycle is distinguished at the doctoral level. In documents on the Bologna process it is advocated to harmonise the structure and requirements of the doctorate, which in Europe are characterised by a wide variety. Differences exist in all possible requirements between countries, and even between schools within one country differences can be seen. In this paper an inventory is made of these differences in the dental doctorate between European countries. Moreover, the need for necessary harmonisation of requirements for a European dental doctorate is strongly advocated and a proposal is presented.

Benefits of periodontal therapy when preterm birth threatens.

There is growing evidence that chronic periodontitis may be a risk factor for pre-term birth. The goal of this intervention study was to determine the effect of periodontal treatment on the pregnancy outcome in women with threatening pre-term birth and initial localized chronic periodontitis. Forty-one women with a singleton pregnancy were enrolled in the study. For this treatment group, oral hygiene instruction and periodontal therapy were provided in the third trimester, while those in the control group (42 persons) did not receive any periodontal treatment. In the treatment group, the mean weight of newborns was 3079.0 g, compared with the control group mean of 2602.4 g. The incidence of pre-term birth and low birthweight in the treatment group was significantly less than in the control group (p = 0.015). Periodontal treatment completed before the 35th week appeared to have a beneficial effect on birth weight and time of delivery.

Epidural anesthesia? No of course.

Although the contraindications for thoracic epidural anesthesia (TEA) are well defined, the debate continues about whether TEA improves outcomes. Pro and con trials and a metaanalysis in the past have yielded equivocal results; they did not deal with new vascular intervention or drugs. The benefit of TEA in surgery is to provide analgesia. In subgroups, TEA can decrease the mortality and morbidity. In contrast, the cost can increase in the situation of a complication that is opposite to the side effects is rare, but the impairment caused by them is out of proportion to the benefits. Primary or secondary prophylaxis with antithrombotic drugs is increasing in developed countries because of the increasing cardiovascular interventions and aging of the population. The neuroaxial guidelines are useful, but the changing of the coagulation profile after hepatectomy is not included in them. The decision to use TEA in liver surgery must be individualized with steps planned from the beginning. TEA suitability is based on an evaluation of the contraindications, comorbidities, coagulation profiles, hepatic reserve, and balance of benefits and risks. The insertion or withdrawal of the epidural catheter should be made with care according to the neuroaxial guidelines and in the presence of a normal TEG. The decreasing level of prothrombin content and platelet counts after hepatectomy should be closely monitored every 2 to 5 days.

Staff recruitment, development and global mobility.

This paper considers issues that relate to staff recruitment, staff development and global mobility of dental academics. Published literature, which has a North American bias, is reviewed. Recommendations, which may be applicable world-wide, are made to address evident and pertinent areas of concern in terms of the availability of quality dental teaching staff in dental teaching institutions so as to sustain the global dental academic enterprise at appropriately high levels of achievement.

Surface modifications induced by ns and sub-ps excimer laser pulses on titanium implant material.

Medical implants used in oral and orthopaedic surgery are mainly produced from titanium. Their biological behaviour, e.g. osseointegration, essentially depends on both the chemical composition and the morphology of the surface. Modifications achieved by excimer laser irradiation of titanium samples were investigated in order to improve their surface characteristics so as to facilitate biointegration. To enlarge the effective interfacial area of bone-implant contact, holes were ablated by laser pulses of ns or sub-ps length. During ns ablation, crown-like projecting rims formed around the borders of the holes. Ultra-short (0.5ps) KrF excimer laser pulses were successfully applied to avoid these undesirable formations. Since a smooth dental implant surface is necessary to maintain a healthy connection with the soft tissues, laser polishing of samples was investigated, too. Irradiation with a series of ns laser pulses resulted in effective smoothing, as measured with atomic force microscope. X-ray photoelectron spectroscopy analysis of the laser-polished titanium surface revealed that laser treatment led to a decrease of the surface contamination and in thickening of the oxide layer. X-ray diffraction measurements demonstrated that the original alpha-titanium crystal structure was preserved.

[Adsorption of human serum proteins to titanium dioxide]. / Humán szérumfehérjék adszorpciója titán-dioxidhoz.

In order to find an in vitro biochemical model for investigation of osseointegration in terms of dental implantology, the aim of the present study was to analyse the adsorption of human serum proteins to titanium dioxide. Titanium dioxide powder was suspended in human serum. After incubation and centrifugation the TiO2 with the adsorbed proteins were washed with distilled water, ethylendiaminetetraacetic acid (EDTA) supplemented with ammonium hydrogencarbonate (NH4HCO3) solution, and sodium dodecylsulphate (SDS), after centrifugation the supernatant fluid was collected and SDS polyacrylamide gel and native (Biomidi) gel electrophoresis were conducted to determine the type of the adsorbed proteins. Our results show, that albumin was adsorbed to TiO2, but it could be easily removed. The adsorption of a 94 kDa protein was much stronger than the other proteins. The method seems to be useful in the investigation of the protein adsorbing ability of differently treated titanium implant surfaces.

[Clinical study of tooth-to-implant supported fixed partial dentures]. / Implantátumon és természetes fogon rögzített hidak klinikai vizsgálata.

The lack of the periodontal ligaments around the implants results an ankylotic fixation. The mobility of the osseointegrated implants is only one tenth of the mobility of the natural teeth. To connect a natural tooth and an implant as abutments in a fixed restoration is a special problem in the dentistry. The aim of this study was to examine whether connecting of implants and natural teeth has any disadvantages for the abutment either implant or natural tooth. Furthermore we wanted to know if an overloading of the opposing tooth could occur because of the stiffness of the implant-bone connection. 21 partially edentulous patients, who were treated with implant supported bridges using the DenTi implant system which includes screw-shaped, commercially pure titanium implants, were examined. Plaque, calculus, gingival index, probing depth and bleeding on probing were recorded around the implants and the teeth. Mobility, sound on percussion were examined as well. In this study no disadvantageous effect of connecting teeth to implants as abutments by fixed partial dentures was found. There was no sign of a harmful effect of the implant to the opposing teeth either. The tooth-to-implant bridges function in their biological environment without affecting it adversely.

[Effect of preventive fluoride treatment in childhood on dental conditions in adults]. / Gyermekkori fluoridprevencióban részesült felnöttek fogazati állapota.

The purpose of the study was to compare the dental health status of three groups of adults aged 18-47. In the first group belonged the population, that consumed in their childhood salt containing 250-350 mg fluoride per kg. The second group consisted of those who drank water with an optimal fluoride concentration (1 mg/kg). The individuals without fluoride prevention formed the third group. The results showed, that the consumption of fluoridated drinking water or salt in childhood has a life-long beneficial effect on the dental health of the adult population.

[Hygienic considerations of fixed bridges]. / Rögzített hidak szájhigiéniai vonatkozásai.

The purpose of the present study was to examine whether the pontics form in the everyday practice suits the hygienic requirements. 74 bridges in 30 individuals were examined with clinical methods. 58 per cent of the restaurations had a concave surface towards the alveolar ridge. More than the half of the bridges were resting on the underlying mucosa. The patients didn't know the special instruments, that are necessary to clean the pontics and they weren't taught how to do it. In consequence of these facts only 7 pontics were found without plaque accumulation on their gingival surface. Methods are offered by the authors to improve the conditions of the better oral hygiene of the patients with fixed partial dentures.

[Improvement of the stability of the total lower prosthesis by vestibuloplasty]. / A teljes alsó protézis stabilitásának javítása vestibulumplasztika segítségével.

An up-to-date method of vestibuloplasty is shown by a case report. The flap raised from the cheek is suitable to cover the surface of the anterior alveolar process made free during the deepening of the lower vestibular fold. The recipient and donor areas are both within the oral cavity, thus the procedure is simple and the patients can bear it without difficulty. Due to the new anatomical situation the functional stability of complete dentures is considerably increased.