Cataract surgery with foldable intraocular lens implants in captive lowland gorillas (Gorilla gorilla gorilla).

Two juvenile, male, captive-born lowland gorillas (Gorilla gorilla gorilla) with the same father but different mothers developed bilateral cataracts. The cataracts were surgically removed within 6 yr and 3 mo, respectively, of diagnosis, and foldable intraocular lenses were implanted. Although vision was not restored in one eye with a mature, 6-yr-old cataract in gorilla A, surgical intervention on the other eye was performed before a complete cataract developed, and vision was fully restored. Gorilla B was treated at the age of 17 mo, and normal visual development proceeded in both eyes. This animal developed bilateral after-cataract and therefore needed a second intervention in both eyes using Nd:YAG laser treatment. The genetic component of juvenile cataracts should be considered in breeding management programs.

[Gold partial restorations - quo vadis?]. / Gegoten partiële restauraties - quo vadis?

In the light of the question if there is still an indication for cast gold partial restorations, it is concluded that adhesive dentistry with composite and porcelain has superseded the gold inlay. However, gold onlays with their periodontium friendly characteristics and longevity are still indicated for patients who do not object to gold visible in the oral cavity.

[Staining the lens capsule with trypan blue for visualizing capsulorhexis in surgery of mature cataracts]. / Färbung der Linsenkapsel mit Trypanblau zur Visualisierung der Kapsulorhexis bei Maturkataraktchirurgie.

BACKGROUND: A capsulorhexis may be difficult to perform in the absence of a red fundus reflex. PATIENTS AND METHODS: After application of 0.3 mL trypan blue 0.1%, a quick and homogeneous staining of the anterior lens capsule was obtained in 100 patients with a mature cataract, to visualize the capsulorhexis during a phacoemulsification procedure. RESULTS: No adverse reactions related to the dye were observed up to 18 months after surgery. CONCLUSION: Trypan blue staining of the anterior lens capsule may therefore be a safe technique to facilitate the performance of a capsulorhexis in the absence of a red fundus reflex.

[Porcelain onlays]. / Porseleinen onlays.

This article covers the clinical application of feldspathic porcelain onlays. The indication, tooth preparation, try-in and cementation procedures using total etching and the latest concepts in dentin bonding are discussed. When properly executed fired porcelain onlays can meet the highest esthetic demands but they require maximum skills, both of the dental surgeon and of the dental technician.

Comparison between postoperative astigmatism after classic extracapsular lens extraction and after phacoemulsification with implantation of a Pearce tripod or Pearce vaulted Y-loop intraocular lens.

We compared the surgically induced astigmatism after standard extracapsular cataract extraction (ECCE) with the astigmatism following cataract extraction by phacoemulsification. The surgically induced corneal astigmatism was assessed on several occasions, ranging from one day to one year postoperatively. After phacoemulsification, this astigmatism was considerably slighter than after ECCE on day 1 postoperatively and after two and six weeks. However, one year postoperatively, this difference was less clear. We then measured slight against-the-rule astigmatism for both surgical techniques.

[Esthetic aspects of crowns and bridges]. / Esthetische aspecten van kronen en bruggen.

By means of discussing several guiding principles a protocol is suggested and treatment procedures are outlined which will result in optimum esthetics in the fabrication of crowns and bridges. Some important considerations in restoring an occlusion with porcelain are discussed.

[Replacement of anterior teeth with bridges]. / Tandvervanging in het front door bruggen.

Missing incisors and canines may be replaced with preferably gold-porcelain bridges. To be acceptable in an esthetical sense, the bridge demands, apart from a correct colour and shape, a healthy periodontium, the latter being the subject of this paper. The way in which the outline is prepared, the relationship between depth of the preparation and marginal gingiva and the prevention of periodontal trauma are discussed.

Intraocular lens implantation in children with unilateral traumatic cataract.

A group of 23 children with traumatic pseudophakia was evaluated. Intraocular lens (IOL) implantation was performed as a primary procedure, immediately after aspiration of the traumatic lens, in 7 cases and as a secondary procedure in 16 cases. The mean followup was 6.5 years, varying from 1.5 to 11 years. A visual acuity of 0.7 or more was achieved in 3 of the 8 patients under 7 years of age and in 13 of the 15 cases from 7 to 14 years of age. Awaiting longer follow-up results of epikeratophakia in children we advise to perform early IOL implantation in children under 7 years of age, combined with a rigid amblyopia treatment scheme. In children older than 7 years of age we prefer to try the use of contact lenses first and preserve IOL implantation for selected cases.

The role of the general practitioner in restoring patients with temporomandibular joint dysfunction.

Treatment of temporomandibular joint pain, resulting from occlusal dysfunction, is divided into two phases. First, occlusal splint therapy is used to eliminate the initial signs and symptoms and to achieve stability in centric relation. In the second phase of treatment the occlusion is adjusted and, if indicated, restored by means of crown and bridge procedures. Casts, properly mounted in a semi-adjustable articulator, with the lower cast mounted in centric relation, can be extremely helpful for an occlusal analysis and a diagnostic occlusal adjustment in the articulator. Each occlusal adjustment procedure in the mouth should be preceded by an initial study, occlusal analysis and occlusal adjustment on articulator mounted casts. The two main criteria for restoring the occlusion are: maximum intercuspation occurring in centric relation and disocclusion of the posterior teeth during excursive movements by means of anterior guidance. Patients with a history of temporomandibular joint pain and dysfunction usually have a limited adaptive capacity of even the smallest occlusal imperfection. In order to cope with the occlusal restoration of patients with such a low level of occlusal tolerance the final crowns and bridges should be cemented temporarily for a period of at least 3 months. A matt gold surface will be very helpful to locate undesirable occlusal contacts during temporary cementation.