Disease burden in four populations of dog and cat breeds compared to mixed-breed dogs and European shorthair cats.

Current public and professional opinion is that many dog breeds suffer from health issues related to inherited diseases or extreme phenotypes. The aim of this historical comparative observational study was to evaluate the breed-related disease burden in three purebred dog populations (Chihuahua, French bulldog, Labrador retriever) and one purebred cat breed (Persian cats) in the Netherlands by comparison to a control population of mixed-breed dogs and European Shorthair cats. A qualitative query was performed, consisting of a literature review and collecting the expert opinions of University veterinary specialists, to gather insight into potential diseases of the study population. Next, a referral clinic case control study of the patients referred to specific medical disciplines in the University Clinic was performed. The odds ratio (OR) was calculated to determine the likelihood of a patient referred to a particular medical discipline being a certain breed. Together, the qualitative query and the case control study resulted in a list of potentially relevant diseases limited to five organ systems per breed. These were analysed in data from primary practices. Patient files from ten primary practices over a period of two years were manually extracted and examined. Four-hundred individual patient records per breed as well as 1000 non-breed records were randomly selected from the 10 practices, weighted per practice size. Records were then examined and the presence or absence of certain diseases was identified. To evaluate the disease burden per breed, proportional difference (PD) was estimated, as well as the animal's age at presentation in months. The results of the referral clinic case control study showed an overrepresentation (Odds Ratio>1.5) of the selected breeds in several medical specialties, while median age at presentation was in some cases significantly lower than in the non-breed animals. Results of the practice-based extended cross-sectional study showed that only a few of the selected diseases contribute to the disease burden in these purebred populations, which was different from the expectations derived from the literature or expert opinion. Additional results included age difference at presentation, which may be interpreted as age of onset, and could indicate a higher disease burden for the individual animal. Also, only a small percentage of purebred dogs was registered with the national kennel club. Our final recommendation is that population-based data mining is needed to evaluate country-specific companion animal health and welfare.

Clinical and radiographic characteristics of single-tooth replacements preceded by local ridge augmentation: a prospective randomized clinical trial.

OBJECTIVES: To assess in a randomized-clinical trial the influence of three augmentation techniques (chinbone with or without a Bio-Gide membrane and Bio-Oss with a Bio-Gide membrane) on the clinical and radiographic characteristics of hard and soft tissues around implants and adjacent teeth in the reconstructed maxillary anterior region, up to 1 year after functional loading. MATERIALS AND METHODS: Ninety-three patients requesting single-tooth replacement and presenting with a horizontal (bucco-palatinal) bone deficiency were included. After augmentation, 93 ITI-Esthetic(Plus) implants were placed. Clinical variables, standardized photographs and radiographs were analysed to assess the impact on the levels of the marginal gingiva (MGL) and marginal bone (MBL) around implants and adjacent teeth, viz at pre-augmentation, pre-implantation (TPI) and 1 (T(1)) and 12 (T(12)) months after final crown placement. RESULTS: Implant survival was 97.8%. No significant differences were observed in the treatment outcomes of the three augmentation modalities. Combining the three modalities, a slight but significant increase in the implants approximal pocket depth was found between T(1) and T(12). Approximal bone loss at the implant between T(1) and T(12) was 0.14 +/- 0.76 mm (mesial) and 0.14 +/- 0.47 mm (distal); the approximal MGL slightly increased (mesial: 0.24 +/- 0.46 mm, distal: 0.25 +/- 0.66 mm), and the buccal MGL decreased (0.11 +/- 0.61 mm). Bone loss at the adjacent teeth, although minor, was significant between TPI and T(1). No correlations were observed in changes of MBL and MGL. CONCLUSIONS: None of the three applied augmentation technique procedures influenced the characteristics of the MGL and MBL or the implant survival of single-tooth replacements. Peri-implant hard and soft tissues were very stable in the first year after loading.

[Surgical dilemmas. Bone augmentation procedures for single-tooth replacements]. / Chirurgische dilemma's. Donorlocaties voor botaugmentatie bij enkeltandsvervanging.

When, following the loss of one or more teeth, insufficient bone is present for the placement of a dental implant, bone augmentation is indicated. For large bone defects (e.g. severely atrophic edentulous jaws and large vertical/horizontal bony defects larger than 3 teeth), an autogenous bone transplant from an extra-oral donor site (iliac crest) will have to be chosen. An autogenous bonegraft is also usually preferred for vertical bone deficiencies, though this can generally be harvested in the oral region. For smaller bone defects, augmentation with autogenous bone from the oral region (mandibular ramus, symphysis region) can be selected or a bone substitute.

[Bisphosphonate-associated osteonecrosis of the jaws. 3. Two case reports]. / Bisfosfonaatgerelateerde osteonecrose van de kaak. 3. Twee casussen.

The cases presented show that bisphosphonate-induced osteonecrosis of the jaw is difficult to treat. Recently, a classification of bisphosphonate-induced osteonecrosis of the jaw based on clinical appearance was published. On the basis of this classification the seriousness of the osteonecrosis can be evaluated and a method of treatment determined. The common opinion is that treatment should be as conservative as possible. This means that treatment should have as its objective the prevention of the spread of the disease by means of antibiotics and disinfectant mouthwash. Sharp bony edges may be trimmed. Extensive surgical treatment should be reserved for those rare cases in which the osteonecrosis is progressive.

[Osteonecrosis of the jaws: a secondary effect of bisphosphonates]. / Nécrose osseuse des mâchoires: un effet secondaire des biphosphonates.

When treated with intravenous bisphosphonates to prevent bone resorption, 4-10% of the patients may develop osteonecrosis of the jaws a side effect. The osteonecrosis is usually preceded by an invasive dental procedure such as the removal of a tooth. Treatment of the osteonecrosis should be conservative using aseptic mouth rinses, oral antibiotics and small debridement. It seems advisable to have a dental check-up before starting using intravenous bisphosphonates, since a potential dental infections can be treated before the bone healing capacity is reduced by the bisphosphonates.

Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone.

The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1-3mm). Reconstruction was performed with chin bone (N=5), chin bone and a resorbable Bio-Gide GBR membrane (N=5) or Bio-Oss spongiosa granules in combination with a Bio-Gide GBR membrane (N=5). Biopsies were taken prior to implantation, i.e. 3 months after grafting with chin bone, and 6 months after grafting with Bio-Oss. Evaluation was done by assessing the histological and histomorphometric characteristics of full-length biopsies taken from the actual implant site. Both areas with non-vital bone and areas with apposition of bone and remodelling phenomena were observed in the chin bone group at the time of placement of the implants. Similar results were observed at implant sites reconstructed with a chin bone graft covered by a membrane. In the chin bone group without and with a GBR membrane, the mean total bone volume (TBV) was 55.2+/-6.8% and 57.7+/-11.5%, respectively; the marrow connective tissue volume (MCTV) was 44.8+/-6.8% and 42.3+/-11.5%, respectively. Remnants of the resorbable GBR membrane were not detected. In the Bio-Oss((R)) group, at implant placement some newly formed bone was observed in the connective tissue surrounding the Bio-Oss((R)) particles (mean TBV (newly formed bone) 17.6+/-14.5%), but most particles were surrounded by connective tissue. No convincing signs of remodelling were observed (mean remaining Bio-Oss volume 40.5+/-9.3%; mean MCTV 41.9+/-13.1%). No implants were lost during follow up (12 months). At the time of placement of the implants the grafting material (either chin bone or Bio-Oss is still not fully replaced by new vital bone. In case of Bio-Oss, most of the grafting material is even still present. Despite these differences, the 1-year clinical results were very good and comparable between the various grafting techniques applied.

[Syndromes 13. Epidermolysis bullosa]. / Syndromen 13. Epidermolysis bullosa.

Epidermolysis Bullosa is characterised by blister formation of skin and mucous membranes. Three major varieties of epidermolysis bullosa (EB) are reviewed including their dental and oral aspects: EB simplex, junctional EB and dystrophic EB. Marked oral involvement of the soft and hard tissues can produce potentially devastating alterations in anatomy and function. Oral debilitation is limited primarily to the recessive dystrophic EB type due to soft tissue scarring following blister formation. Microstomia, ankyloglossia and obliteration of the oral vestibule are typical features of dystrophic EB. In other cases enamel hypoplasia and cementum disorders can be present. Epidermolysis bullosa has considerable impact on oral health and dental care.

[Alveolar ridge augmentation with hydroxylapatite. A clinical evaluation]. / Hydroxylapatiet-augmentatie. Een klinische evaluatie.

In a retrospective study on the effects of an absolute augmentation of the atrophic alveolar ridge with hydroxylapatite, the patient satisfaction rate with the present denture and the loss in height of the augmentation were assessed. Most patients indicated an improved functioning with their dentures after the operation; nevertheless, the patient satisfaction rate was lower than expected. Additionally a concerned loss in height of the augmentation was demonstrated over the evaluation period of 3.5 years. In selected cases, however, the hydroxylapatite augmentation of the atrophic alveolar ridge may still have its value in preprosthetic surgery.