Metal hypersensitivity and pro-inflammatory cytokine production in patients with failed orthopedic implants: A case-control study.

Orthopedic implants heal well without complications in most patients but fail for unclear reasons in some individuals. This study determined the relevance of metal hypersensitivity in patients with failed orthopedic implants and those requiring orthopedic implant surgery. The study included 35 patients with failed orthopedic implants and 15 subjects scheduled for orthopedic implant surgery. The production of selected pro-inflammatory cytokines was measured in patients with failed orthopedic implants. Metal hypersensitivity was measured in all subjects using the MELISA® test. Of common metals in orthopedic alloys, the patients with failed orthopedic implants responded most frequently to nickel, chromium, titanium, iron, and molybdenum. Hypersensitivity to metals found in implants was measured in 40% of patients with failed implants. The study also showed that titanium exposure in patients with titanium hypersensitivity might lead to implant failure. Metal hypersensitivity testing should be offered to patients before surgery to minimize the risk of implant failure.

Titanium and Other Metal Hypersensitivity Diagnosed by MELISA® Test: Follow-Up Study.

This study is aimed at proving the clinical benefit of the MELISA® test in the minimization or complete elimination of health problems in patients with confirmed hypersensitivity to metals used for tissue replacements. A group of 305 patients aged 20-75 years with previously proven metal hypersensitivity (initial MELISA® test), mainly to titanium and then to another fifteen metals, was chosen from the database at the Institute of Dental Medicine. From these patients, a final group of 42 patients agreed to participate in the study, 35 of which were female and 7 were male. The patients completed a special questionnaire aimed at information regarding change of health status from their last visit and determining whether the results of the initial MELISA® test and recommendations based on it were beneficial for patients or not. They were clinically examined, and peripheral blood samples were taken to perform follow-up MELISA® tests. Questionnaire data was processed, and the follow-up MELISA® test results were compared with the results of the initial MELISA® tests. For statistical analysis, the Fisher's exact test and paired T-test were used. Thirty-two patients reported that they followed the recommendations based on the results of the initial MELISA® tests, and of these, 30 patients (94%) confirmed significant health improvement. Six patients did not follow the recommendation, and from these, only one patient reported an improvement in his health problems. By comparison of the initial and follow-up MELISA® test results, it can be stated that the hypersensitivity to the given metal decreased or disappeared after the therapeutic interventions performed based on the initial MELISA® test results. The evaluation of the data obtained from patients in this study confirmed a significant clinical benefit of MELISA® test.

Comparison of dental and chronological age based on CBCT-generated panoramic images and reconstructed 3D images.

Objective: The aim of the present study was the comparison of the known chronological age of the studied subjects by dental age evaluated according to the developmental stages of seven permanent teeth in the lower left dental quadrant and to determine how much the child's dental age differs from its chronological age. Methods: Radiographs of 579 patients (288 boys and 291 girls), aged 3-16 years, from the database of the Radiological Clinic of the Second Medical Faculty of Charles University and the Motol University Hospital in Prague were reviewed. The patients were examined for different indications by cone beam computed tomography (CBCT). The evaluation of the developmental stages of the teeth was performed from generated panoramic images and reconstructed three-dimensional (3D) images. The developmental stages of the teeth were evaluated by Demirjian's method for dental maturity based on seven teeth of the lower left dental quadrant (Demirjian et al. 1973). The evaluated variables were mineralization and development of the dental crown, length of the root, and closure of the apical foramen. Results: The difference between chronological and dental age was -0.16 (standard deviation (SD) 1.68, p-value 0.7) in boys and -0.10 (SD 1.65, p-value 0.27) in girls, on average. These results confirm that the method is accurate. Low SD values express the precision of the evaluation. Conclusion: Use of reconstructed 3D images makes the evaluation of the maturation of teeth more accurate in comparison to the use of generated panoramic images. The development of teeth (with exception of third molars) was complete at the age of 16 in 97.3% of the studied subjects.

C-reactive protein in patients with aggressive periodontitis.

BACKGROUND/PURPOSE: The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP) in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. MATERIALS AND METHODS: All patients (N = 45) were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23) and group LAgP (Localised form of aggressive periodontitis, N = 22). Control group (CON) included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. RESULTS: CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP) in a similar way as bleeding on probing (BOP) and probing pocket depth (PPD) indices. CONCLUSION: Our study results showed that CRP levels, as well as bleeding on probing (BOP) and probing pocket depth (PPD), indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis.

Using Dental Age to Estimate Chronological Age in Czech Children Aged 3-18 Years.

The Demirjian methods to determine dental age are based on analysis of orthopantograms. The dental age estimation is based on establishing the tooth development stages. The purpose of this study was to assess the accuracy of estimation of dental age by Demirjian in the use of all of his four methods. 505 Czech healthy boys and girls aged 3 to 18 years were examined radiographically at the Department of Stomatology, Second Faculty of Medicine, Charles University in Prague. It was mentioned the factors of underlying diseases influence the accuracy of the dental age estimation. For statistical evaluation, descriptive statistics was used to compare deviations of the mean values of chronological and dental age in each age group. The resulting difference between dental age and chronological age is not significant in both genders only when using both Demirjian 7-teeth methods of 1973 and 1976. Therefore these may be most appropriately used for forensic age estimation. There are shown standard deviation differences in different countries. Demirjian's original 7-teeth method from 1973 and Demirjian's revised 4-teeth method from 1976 appear to be the best methods for calculating the dental age of healthy Czech children of both genders.