Timing of antenatal corticosteroid administration in pregnancies with increased risk for premature birth: A retrospective cohort study.

OBJECTIVE: To investigate how often antenatal corticosteroids (ACS) were administered within the optimal time frame in women at risk of preterm birth (PTB) in relation to several diagnoses and risk factors. METHOD: The study was designed as a retrospective cohort trial, in which the data of all births taking place in 2016 in the German federal state of Rhineland-Palatinate were evaluated. Frequency analyses, subgroup analyses, and logistic regression were performed. RESULTS: Birth occurred within the ideal time frame (≥24 h, ≤7 days) in only 15.2% of all pregnant women who were treated with ACS because of an increased risk of PTB (N = 1544). The ideal time frame after ACS administration was reached in less than 25% of all cases in each subgroup, with little difference between the different diagnoses and risk factors for PTB (range 11.3%-22.2%). Patients with multiple pregnancy had a significantly higher chance for delivery within the ideal time frame. There was an odds ratio greater than 1 for a birth event within the ideal time frame in patients with preterm prelabor rupture of membranes, pre-eclampsia, oligohydramnios, amniotic infection syndrome, and in patients with multiple diagnoses. In most diagnoses, the average time between ACS administration and birth was significantly shorter compared with patients without the diagnosis or risk factor. CONCLUSION: In women at risk of PTB, the individual risk profile should first be identified before ACS management begins. The likelihood of achieving the ideal time frame additionally depends on the diagnosis.

HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH.

BACKGROUND: When dental patients seek care, treatments are not always successful,that is patients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in dentistry, but a promising statistical technique to identify non-responders in particular and clinical distinct patient groups in general in longitudinal data sets. AIM: Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA). METHODS: This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory GBTM was performed to identify treatment response patterns. RESULTS: Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological impairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated. CONCLUSIONS: Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investigate which dental treatment works for which patients.

Tooth loss in periodontally treated patients: A registry- and observation-based analysis.

AIM: According to retrospective clinical studies, periodontal treatment retains teeth. However, evidence on the effectivity of periodontal treatment stemming from the general population is lacking. MATERIALS AND METHODS: We analysed data of periodontally treated patients from routine data of a major German national health insurance (BARMER-MV; sub-sample of the Federal State of Mecklenburg-Vorpommern) and from a clinical cohort (Greifswald Approach to Individualized Medicine, GANI_MED), as well as periodontally untreated and treated participants of the Study of Health in Pomerania (SHIP-TREND) with either ≥2 or ≥4 teeth with pocket depths ≥4 mm. Yearly tooth loss (YTL) estimates and incidence rates were evaluated. RESULTS: For moderately to severely affected groups, YTL and incidence rates were higher in BARMER-MV patients (0.35 and 0.18, respectively) than in untreated SHIP-TREND controls (0.19 and 0.08, respectively). In line, treated SHIP-TREND participants exhibited higher YTL rates than untreated SHIP-TREND controls (0.26 vs. 0.19). For severely affected groups, results with respect to tooth loss were inconclusive regarding the beneficial effects of periodontal treatment conducted either in the university (GANI_MED data) or in the general practice. CONCLUSION: Until 2021, periodontal treatment performed in German general dental practices within the national health insurance system was probably not efficient in retaining more teeth in the short- to mid-term. Since reimbursement schemes were changed in 2021 and now cover periodontal treatment to a much larger extent, the future will show whether these new reimbursement codes will improve the quality of periodontal treatment and whether they will lead to more long-term tooth retainment.

Three-year clinical performance of posterior monolithic zirconia single crowns.

STATEMENT OF PROBLEM: Monolithic zirconia has become widely used for single crowns, with the advantages of minimal tooth reduction and good esthetics. However, clinical studies evaluating the performance of and patient satisfaction with posterior monolithic zirconia crowns are sparse. PURPOSE: The purpose of this clinical study was to evaluate the clinical performance of and patient satisfaction with posterior monolithic zirconia crowns. MATERIAL AND METHODS: Within a prospective cohort study design, participants were recruited from a university dental clinic if they required 1 posterior monolithic zirconia crown. The clinical performance was evaluated at follow-up appointments 1, 2, and 3 years after insertion. Bleeding on probing and pocket probing depths for the crowned teeth were recorded. Overall patient satisfaction was measured by using a visual analog scale (VAS), and quality of life was measured by using the validated German version of the Oral Health Impact Profile 14 (OHIP-G14). Descriptive statistical methods were applied. Mean values were calculated and compared by using the paired t test (α=.05). RESULTS: Thirty participants received a monolithic zirconia crown (14 premolars, 16 molars). One biologic complication (vertical root fracture) was identified at the 1-year follow-up. Three years after insertion, 22 participants could be examined, and the crowns were still in function. The gingival and the periodontal status of the crowned teeth had not changed significantly over the 3 years. After insertion, a significant improvement in patient satisfaction was measured up to 3 years CONCLUSIONS: Posterior monolithic zirconia crowns led to enhanced patient satisfaction up to 3 years after insertion. They provided good middle-term success and offered a promising alternative to conventional metal-ceramic crowns.

Performance of fixed dental prostheses up to 6 years-A massive data analysis.

STATEMENT OF PROBLEM: Metal and metal-ceramic fixed dental prostheses (FDPs) have been clinically determined to provide long-term durable restorations. However, data on their performance under practice conditions are sparse. PURPOSE: The purpose of this clinical study was to evaluate the longevity of FDPs under practice conditions by analyzing a large insurance claims database. MATERIAL AND METHODS: Data were extracted from the data warehouse of a major German national health insurance company (BARMER). The analysis focused on the FDP types with the lowest deductibles in the insurance system. All metal-based FDPs replacing up to 3 adjacent teeth were included. Ceramic veneering was optional and only approved on the labial surfaces of maxillary teeth mesial to the first molar and mandibular teeth mesial to the second premolar. Fee codes allowed clinical courses to be traced on a day count basis. Three groups with FDPs replacing 1 tooth, 2 teeth, and 3 teeth were formed. Kaplan-Meier survival analyses were conducted for the target events removal or extraction, indicating FDP failure and extraction of an abutment tooth. RESULTS: The sample comprised 124 660 FDPs that replaced 1 tooth (76.5%), 2 teeth (19.8%), or 3 teeth (3.7%). The cumulative survival rates for removal or extraction at 6 years differed significantly, with 83.0% for 1-pontic FDPs, 78.1% for 2-pontic FDPs, and 74.0% for 3-pontic FDPs. Thus, approximately 1 of 6 one-pontic FDPs, 1 of 5 two-pontic FDPs, and 1 of 4 three-pontic FDPs failed. The cumulative survival rates for extraction of an abutment tooth at 6 years showed no significant difference, with 96.0% for 1-pontic FDPs, 95.6% for 2-pontic FDPs, and 95.1% for 3-pontic FDPs. CONCLUSIONS: The survival rates of FDPs according to insurance data were lower than those reported by clinical studies, indicating a gap between efficacy and effectiveness.

Anterior occlusion in shortened dental arches.

OBJECTIVES: The aim of this study was to examine the occlusion of anterior teeth in individuals with shortened dental arch (SDA). MATERIAL AND METHODS: In a case-control clinical study, 41 individuals with SDA and 41 individuals with complete dental arch (CDA) participated. The CDA control group was matched for age and gender. Testing for occlusal contacts of anterior maxillary teeth was conducted by biting on foil strips (8 µm) with subjectively normal bite force (NBF) and maximal bite force (MBF). The data was analyzed on individual and tooth levels. RESULTS: The median rates of anterior maxillary teeth with occlusal contacts were 0.67 (NBF) and 0.83 (MBF) in the SDA group and 0.50 (NBF) and 0.83 (MBF) in the CDA group. Within both groups, the contact rates were significantly higher in MBF. The group difference with NBF was significant. A generalized linear model showed that the odds of an anterior maxillary tooth to have an occlusal contact were greater in the SDA both for NBF with an odds ratio (OR) 2.277 and MBF with an OR 1.691. CONCLUSIONS: The findings suggest effective compensatory mechanisms relative to the occlusal function in individuals with SDA. CLINICAL RELEVANCE: The study delivers further evidence regarding the SDA concept as a viable option in the management of posterior tooth loss.

The Role of Oxytocin and the Effect of Stress During Childbirth: Neurobiological Basics and Implications for Mother and Child.

The neuropeptide oxytocin acts as a hormone and a neuromodulator, influencing a multitude of human social behaviors, including reproduction. During childbirth and the postpartum period, it plays a key role in regulating and controlling processes that ensure a safe birth and the health of mother and child. Especially the onset of labor, the progress of labor and initial breastfeeding are mediated by oxytocin. In the maternal brain it controls the initiation of the mother-infant bond and the mother's emotional responses towards her child. In this review we summarize the current state of knowledge about the role of oxytocin during the different aspects and mechanisms of human childbirth, combining research from human and animal studies. Physiological and psychological stress during childbirth and lactation can have negative effects on the progress of labor, breastfeeding and bonding. We discuss how maternity caregivers can support the positive effects of oxytocin and minimize the effects of stress. Furthermore, we highlight aspects of the basic neurobiological principles and connections where further research is needed to improve our understanding of the regulation and the effects of oxytocin to support maternal and infant health.

Routine Data Analyses for Estimating the Caries Treatment Experience of Children.

Oral health surveys are considered the gold standard for assessing the caries experience of children. Analyses of routine data offer additional opportunities not yet fully explored. This study aimed at estimating the caries treatment experience by mining an insurance claims database. Comprehensive claims data sets were extracted from the data warehouse of a major health insurance company (BARMER, Germany). A surrogate variable for caries experience was formed that reflected the proportion of children without any former potentially caries-related treatment (filling, root canal treatment, and extraction) at ages from 1 to 14 years. The statistical calculations were based on Kaplan-Meier survival analyses. The evaluation for the permanent dentition comprised N = 593,330 children at 6 years and N = 114,568 at 12 years. At 12 years of age, 66.8% had not yet experienced potentially caries-related treatments. This value hints at a significantly higher caries experience at 12 years compared to available epidemiological data. For the deciduous dentition, the respective rates were 74.0% at 6 years and 45.8% at 10 years. Although various sources of bias have to be taken into account, the potential of routine data mining is evident. The approach is supplemental to oral health surveys. It can be useful in coming closer to reality when estimating the caries experience of children. From our results, we conclude that the oral health of up to 14-year-olds in Germany remains in urgent need of improvement.

[Utilization and expenses in dental care : An overview based on routine data from Germany]. / Inanspruchnahme und Ausgaben in der zahnmedizinischen Versorgung : Eine Übersicht auf Basis von Routinedaten aus Deutschland.

BACKGROUND: Utilization and expenses are among the most important parameters of healthcare systems. Moreover, they allow us to draw conclusions about the features and focus of currently practiced dentistry in Germany. OBJECTIVES: The aim was to describe the current status of the utilization of dental services and the related expenses in Germany based on routine data from the statutory health insurance system. MATERIALS AND METHODS: The underlying analyses were taken from the annual dental reports of the statutory health insurance company BARMER. They were based on Germany-wide claims data from 2010 to 2018. RESULTS: The utilization of dental services in Germany with annual rates around 70% is distinctly above average. In 2018, utilization rates for dental fillings in the age groups between 30 and 79 years were consistently around 30% and for new prosthetic restorations and dental crowns in the age groups between 55 and 84 years it was at least 10%. In the field of prevention, there has been a steady increase of screening exams for children (31.9% in 2010 and 35.2% in 2018). For individual prophylactic measures in 6­ to 17-year-olds, no clear trend was discernible (64.0% in 2010 and 65.4% in 2018). The expenses of the statutory health insurance increased moderately. CONCLUSIONS: With the high utilization rate, good prerequisites for prevention-oriented dentistry exist. Although there is a positive trend towards a slight increase in the utilization of preventive services, dental care is still mostly oriented towards invasive intervention. Further promotion of health literacy of the population and incentives promoting prevention can be seen as useful instruments to implement a substantial paradigm shift.

Deletion of BDNF in Pax2 Lineage-Derived Interneuron Precursors in the Hindbrain Hampers the Proportion of Excitation/Inhibition, Learning, and Behavior.

Numerous studies indicate that deficits in the proper integration or migration of specific GABAergic precursor cells from the subpallium to the cortex can lead to severe cognitive dysfunctions and neurodevelopmental pathogenesis linked to intellectual disabilities. A different set of GABAergic precursors cells that express Pax2 migrate to hindbrain regions, targeting, for example auditory or somatosensory brainstem regions. We demonstrate that the absence of BDNF in Pax2-lineage descendants of Bdnf Pax2 KOs causes severe cognitive disabilities. In Bdnf Pax2 KOs, a normal number of parvalbumin-positive interneurons (PV-INs) was found in the auditory cortex (AC) and hippocampal regions, which went hand in hand with reduced PV-labeling in neuropil domains and elevated activity-regulated cytoskeleton-associated protein (Arc/Arg3.1; here: Arc) levels in pyramidal neurons in these same regions. This immaturity in the inhibitory/excitatory balance of the AC and hippocampus was accompanied by elevated LTP, reduced (sound-induced) LTP/LTD adjustment, impaired learning, elevated anxiety, and deficits in social behavior, overall representing an autistic-like phenotype. Reduced tonic inhibitory strength and elevated spontaneous firing rates in dorsal cochlear nucleus (DCN) brainstem neurons in otherwise nearly normal hearing Bdnf Pax2 KOs suggests that diminished fine-grained auditory-specific brainstem activity has hampered activity-driven integration of inhibitory networks of the AC in functional (hippocampal) circuits. This leads to an inability to scale hippocampal post-synapses during LTP/LTD plasticity. BDNF in Pax2-lineage descendants in lower brain regions should thus be considered as a novel candidate for contributing to the development of brain disorders, including autism.

Massive data analyses show negative impact of type 1 and 2 diabetes on the outcome of periodontal treatment.

OBJECTIVES: The aim was to evaluate the impact of diabetes on the outcome of periodontal treatment based on massive data analyses. MATERIALS AND METHODS: Data originated from the database of a major German National Health Insurance. Patients who underwent periodontal treatment were allocated to four groups according to their medical condition: type 1 diabetes (D1), type 2 diabetes with the intake of oral anti-diabetics (D2M), type 2 diabetes without the intake of oral anti-diabetics (D2), and a control group without diabetes (ND). Four-year Kaplan-Meier survival analyses on the patient level and multivariate regression analyses were conducted for tooth extraction. RESULTS: Of 415,718 patients, 4139 matched the criteria for D1, 22,430 for D2M, and 23,576 for D2. At 4 years, the cumulative survival rate (no extraction) was 51.7% in the D1 group, 54.0% in the D2M group, and 57.7% in the D2 group. The ND control group had a significantly higher survival rate of 65.9% (P < 0.0001). In the multivariate analyses, both diabetes types were significantly associated with further tooth loss after periodontal treatment. CONCLUSIONS: The diagnosis of diabetes type 1 or 2 seems to be associated with a higher risk of tooth loss after periodontal treatment. CLINICAL RELEVANCE: The long-term prognosis of teeth in diabetes patients should be judged carefully.

Six-year survival of single crowns - A massive data analysis.

OBJECTIVES: Numerous clinical trials have proven the long-term stability of metal and metal-ceramic crowns. However, data on their performance under practice conditions are rare. PURPOSE: To evaluate the longevity of crowns by means of massive data analyses. METHODS: The data were extracted from the data warehouse of a major German national health insurance company (BARMER, Berlin, Germany). The analysis focused on crown types with the lowest deductibles. Metal crowns and metal-ceramic crowns with ceramic veneering on the vestibular aspects of teeth 15-25 and 34-44 placed from 2012 to 2017 were included. The placement of the crowns, crown removals and tooth extractions were identified using the corresponding fee codes. Kaplan-Meier survival analyses were conducted for the outcomes "crown removal or extraction" and for "extraction". RESULTS: The cumulative six-year survival rates were 88.0 % for the outcome "crown removal or extraction" and 92.5 % for the outcome "extraction" (N = 192,868). The survival functions had slightly steepening but close to linear courses. CONCLUSIONS: The outcome of the treatment with metal and metal-ceramic crowns was moderately inferior in comparison to clinical trials. However, treatment with metal and metal-crowns is judged to be a reliable and safe option under practice conditions. CLINICAL SIGNIFICANCE STATEMENT: Clinicians must inform patients about potential treatment outcomes. Therefore, additional knowledge about single crown outcomes under general practice settings based on large database analyses is important.

Discrimination of small sugar concentration differences helps the nectar-feeding bat Leptonycteris yerbabuenae cover energetic demands.

Every day nectar-feeding animals face an energetic challenge during foraging: they must locate and select flowers that provide nectar with adequate amounts of sugar to cover their very high energy needs. To understand this decision-making process, it is crucial to know how accurately sugar concentration differences can be discriminated. In a controlled laboratory setting, we offered the nectar-specialist bat Leptonycteris yerbabuenae the choice between different sugar solutions covering the entire concentration range of bat-pollinated plants (3-33%). When feeding on solutions below 10% sugar concentration, L. yerbabuenae were unable to cover their energetic demands because of physiological constraints. Their ability to discriminate sugar concentrations was better than that of any other nectar-feeding animal studied to date. At sugar concentrations below 15%, L. yerbabuenae can discriminate solutions differing by only 0.5%. The bats may utilize this fine-tuned ability to select nectar from flowers with reward qualities that provide them with the necessary amount of energy to survive.

Periodontal health in shortened dental arches: A 10-year RCT.

PURPOSE: This analysis focused on periodontal health in shortened dental arches (SDAs). METHODS: In a randomized controlled clinical trial, patients with missing molars in one jaw and at least one premolar and canine on both sides were eligible for participation. In the partial removable dental prosthesis (PRDP) group (n = 79), molars were replaced with a precision attachment retained PRDP. In the SDA group (n == 71), the SDA up to the second premolars was either left as is or restored with fixed dental prostheses. Outcome variables were vertical clinical attachment loss (CAL-V), pocket probing depth (PPD), bleeding on probing (BOP) and plaque index (PLI). For CAL-V and PPD, the changes at six measuring points per tooth were analyzed. For BOP and PLI, patient related rates were calculated for each point in time. Statistical methods included linear regression analyses. RESULTS: In the intention-to-treat (ITT) analysis for CAL-V in the study jaw, the 10 year patient related mean changes were 0.66 mm in the PRDP group and -0.13 mm in the SDA group. The resulting mean patient related group difference of 0.79 mm (95% CI: 0.20 mm-1.38 mm) was significant (p = 0.01). There were no significant differences in the ITT analyses for PPD. For BOP and PLI, significant group differences with more favorable results for the SDA group were found. CONCLUSIONS: In view of lacking substantial differences for CAL-V and PPD, the overall differences were considered of minor clinical relevance. The results add confirmatory evidence to the shortened dental arch concept and its clinical viability (controlled-trials.com ISRCTN97265367).

Prospective study on metal ceramic crowns in private practice settings: 20-year results.

OBJECTIVES: Posterior metal ceramic crowns are still widely used as a standard treatment. The aim of this study was to obtain long-term data on their clinical performance. MATERIAL AND METHODS: Ten private practitioners participated in this prospective practice-based study. Patients were provided with two crowns each. Two groups were formed. The single crown group comprised 95 patients with 190 crowns. The retainer crown group comprised 138 patients with fixed dental prostheses and 276 retainer crowns. RESULTS: For the primary outcome "loss of tooth or crown," 20-year survival rates of 78.8% in the single crown group and 67.8% in the retainer crown group were found. Veneering ceramic defects occurred rather frequently, resulting in respective 20-year technical success rates of 74.2% for single crowns and 62.9% for retainer crowns. However, veneering ceramic defects causing crown losses were very rare events. CONCLUSIONS: The results contribute to our knowledge on long-term outcomes of treatments with metal ceramic crowns and show high survival and success rates over 20 years. CLINICAL RELEVANCE: Posterior metal ceramic crowns are a highly reliable option in private practice settings.

Tooth loss after periodontal treatment-Mining an insurance database.

OBJECTIVES: The aim of this study was to evaluate tooth loss after periodontal treatment. METHODS: The data was collected from the digital database of a major German national health insurance company. Periodontal treatment was the intervention in the treatment group. Kaplan-Meier survival analyses on the patient level with the primary outcome extraction were carried out over four years. A control group without treatment was matched and analysed. Differences were tested with the Log-Rank-test. Extraction incidences were calculated over a matched observation period six years before and four years after treatment for both treatment and control group. RESULTS: A total of 415,718 periodontal treatments could be traced. Focussing on the outcome "extraction", the cumulative four-year survival rate was 63.8% after periodontal treatment. The matched control group without periodontal treatment showed a survival rate of 72.5%. These differences were significant (p < 0.0001). The extraction incidence over time was higher in a four-year period after periodontal treatment compared to a six-year period before periodontal treatment. CONCLUSIONS: The outcome of periodontal treatment was acceptable. In about two thirds of the patients, extractions could be completely avoided within a four year period after treatment. CLINICAL SIGNIFICANCE STATEMENT: This study within the German national health insurance system shows that extractions were not observed after periodontal treatment in the majority of cases. Although periodontitis is a chronic disease, patients suffering from periodontitis have a considerable chance to prevent further tooth loss.

Clinical Fit of Monolithic Zirconia Single Crowns.

PURPOSE: To analyze the clinical fit of monolithic zirconia single crowns (MZSCs) in a prospective cohort study. MATERIALS AND METHODS: A total of 30 posterior teeth were restored with MZSCs. Silicone replicas were made to measure the clinical fit using a stereomicroscope. Measurements were conducted at 17 points per crown at the marginal and occlusal surfaces. RESULTS: The mean clinical fit was 0.104 mm at the crown margin and 0.101 mm at the occlusal surface. Measured distances at the marginal and occlusal surfaces were comparable. CONCLUSION: MZSCs showed acceptable clinical fit.

Strigolactone Levels in Dicot Roots Are Determined by an Ancestral Symbiosis-Regulated Clade of the PHYTOENE SYNTHASE Gene Family.

Strigolactones (SLs) are apocarotenoid phytohormones synthesized from carotenoid precursors. They are produced most abundantly in roots for exudation into the rhizosphere to cope with mineral nutrient starvation through support of root symbionts. Abscisic acid (ABA) is another apocarotenoid phytohormone synthesized in roots, which is involved in responses to abiotic stress. Typically low carotenoid levels in roots raise the issue of precursor supply for the biosynthesis of these two apocarotenoids in this organ. Increased ABA levels upon abiotic stress in Poaceae roots are known to be supported by a particular isoform of phytoene synthase (PSY), catalyzing the rate-limiting step in carotenogenesis. Here we report on novel PSY3 isogenes from Medicago truncatula (MtPSY3) and Solanum lycopersicum (SlPSY3) strongly expressed exclusively upon root interaction with symbiotic arbuscular mycorrhizal (AM) fungi and moderately in response to phosphate starvation. They belong to a widespread clade of conserved PSYs restricted to dicots (dPSY3) distinct from the Poaceae-PSY3s involved in ABA formation. An ancient origin of dPSY3s and a potential co-evolution with the AM symbiosis is discussed in the context of PSY evolution. Knockdown of MtPSY3 in hairy roots of M. truncatula strongly reduced SL and AM-induced C13 α-ionol/C14 mycorradicin apocarotenoids. Inhibition of the reaction subsequent to phytoene synthesis revealed strongly elevated levels of phytoene indicating induced flux through the carotenoid pathway in roots upon mycorrhization. dPSY3 isogenes are coregulated with upstream isogenes and downstream carotenoid cleavage steps toward SLs (D27, CCD7, CCD8) suggesting a combined carotenoid/apocarotenoid pathway, which provides "just in time"-delivery of precursors for apocarotenoid formation.

Reliability of light microscopy and a computer-assisted replica measurement technique for evaluating the fit of dental copings.

The aim of this in vitro study was to assess the reliability of two measurement systems for evaluating the marginal and internal fit of dental copings. Sixteen CAD/CAM titanium copings were produced for a prepared maxillary canine. To modify the CAD surface model using different parameters (data density; enlargement in different directions), varying fit was created. Five light-body silicone replicas representing the gap between the canine and the coping were made for each coping and for each measurement method: (1) light microscopy measurements (LMMs); and (2) computer-assisted measurements (CASMs) using an optical digitizing system. Two investigators independently measured the marginal and internal fit using both methods. The inter-rater reliability [intraclass correlation coefficient (ICC)] and agreement [Bland-Altman (bias) analyses]: mean of the differences (bias) between two measurements [the closer to zero the mean (bias) is, the higher the agreement between the two measurements] were calculated for several measurement points (marginal-distal, marginal-buccal, axial-buccal, incisal). For the LMM technique, one investigator repeated the measurements to determine repeatability (intra-rater reliability and agreement). For inter-rater reliability, the ICC was 0.848-0.998 for LMMs and 0.945-0.999 for CASMs, depending on the measurement point. Bland-Altman bias was -15.7 to 3.5 µm for LMMs and -3.0 to 1.9 µm for CASMs. For LMMs, the marginal-distal and marginal-buccal measurement points showed the lowest ICC (0.848/0.978) and the highest bias (-15.7 µm/-7.6 µm). With the intra-rater reliability and agreement (repeatability) for LMMs, the ICC was 0.970-0.998 and bias was -1.3 to 2.3 µm. LMMs showed lower interrater reliability and agreement at the marginal measurement points than CASMs, which indicates a more subjective influence with LMMs at these measurement points. The values, however, were still clinically acceptable. LMMs showed very high intra-rater reliability and agreement for all measurement points, indicating high repeatability.

The Randomized Shortened Dental Arch Study: Tooth Loss Over 10 Years.

PURPOSE: This study aimed to compare the long-term outcomes of two different nonimplant treatments in the bilateral shortened dental arch (SDA). MATERIALS AND METHODS: In a multicenter randomized controlled clinical trial, patients with complete molar loss in one arch were assigned to one of two different nonimplant treatments. In the partial removable dental prosthesis (PRDP) group, patients were provided with a distal-extension prosthesis retained with precision attachments. In the SDA group, patients were treated according to the SDA concept by preserving or restoring a premolar occlusion. RESULTS: Of the 152 treated patients, 82 reached the 10-year examination independent of their dental or prosthetic status. In the intention-to-treat analysis, the survival rates for tooth loss at 10 years were 0.44 (95% confidence interval [CI]: 0.30 to 0.56) in the PRDP group and 0.52 (95% CI: 0.37 to 0.65) in the SDA group. For tooth loss in the study arch, the survival rates were 0.67 (95% CI: 0.52 to 0.78) in the PRDP group and 0.60 (95% CI: 0.45 to 0.73) in the SDA group. The number of teeth lost was higher than expected. In a multivariate analysis using a multiple Cox regression model, the covariates age (unit: 1 year, Hazard Ratio [HR]: 1.033, P = .03) and DMFT value (unit: 1 tooth, HR: 1.121, P = .03) were significant for time to first tooth loss in the study arch. CONCLUSION: The results suggest an overestimation of the influence of the prosthetic management of the bilateral SDA. In treatment decisions, patient preferences should be considered with appropriate weight.