Surgery for Liver Metastasis of Non-Colorectal and Non-Neuroendocrine Tumors.

Surgery has become well established for patients with colorectal and neuroendocrine liver metastases. However, the value of this procedure in non-colorectal and non-neuroendocrine metastases (NCRNNELMs) remains unclear. We analyzed the outcomes of patients that underwent liver surgery for NCRNNELMs and for colorectal liver metastases (CRLMs) between 2012 and 2017 at our institution. Prognostic factors of overall and recurrence-free survival were analyzed, and a comparison of survival between two groups was performed. Seventy-three patients (30 NCRNNELM and 43 CRLM) were included in this study. Although the mean age, extrahepatic metastases, and rate of reoperation were significantly different between the groups, recurrence-free survival was comparable. The 5-year overall survival rates were 38% for NCRNNELM and 55% for CRLM. In univariate analysis, a patient age of ≥60 years, endodermal origin of the primary tumor, and major complications were negative prognostic factors. Resection for NCRNNELM showed comparable results to resection for CRLM. Age, the embryological origin of the primary tumor, and the number of metastases might be the criteria for patient selection.

The impact of luting agents and stiffness of implant-abutments on marginal adaptation, chipping, and fracture resistance of zirconia crowns.

OBJECTIVES: This in vitro study evaluated the impact of cements and implant analogs with different e-moduli on marginal adaptation, chipping, and the fracture resistance of zirconia crowns. METHODS: 80 crowns (Cercon, DeguDent) were manufactured for 40 polyoxymethylene (POM) and 40 titanium (Ti) one-piece implant analogs and divided into 10 groups: A, zinc oxide phosphate (Hoffmann׳s Cement, Richter&Hoffmann, Berlin, D); B, zinc oxide eugenol (Temp Bond, KerrHawe, Bioggio, CH); C, resin (Variolink II, Ivoclar-Vivadent, Schaan, FL); D, zinc oxide without eugenol (Temp Bond NE, KerrHawe, Bioggio, CH); E, glass ionomer (Ketac Cem, 3M ESPE, Seefeld, D). All samples were thermally mechanically loaded (1.2 × 10(6)× 50 N; 3000 × 5°C/55°C). Marginal adaptation was semiquantitatively evaluated before and after ageing with a scanning electron microscope. After ageing, intact samples underwent a fracture resistance test. RESULTS: The best sealed margins before ageing were achieved with resin and zinc oxide cement and with resin after ageing. Zinc oxide samples showed the most discontinuously sealed margins after ageing and the difference between POM and Ti samples was significant only for zinc oxide. The numbers of samples failing during TCML were as follows: A(Ti - POM)=0-1; B(Ti - POM)=0-5; C(Ti - POM)=1/1; D(Ti - POM)=2-2; E (Ti - POM)=0-2. Fracture resistance test [N]: A(Ti - POM)=1181-801; B(Ti - POM)=1469-1517; C(Ti - POM)=1704-1408; D(Ti - POM)=1992-883; E (Ti - POM)=2750-1015. CONCLUSIONS: TCML reduced the number of perfectly sealed samples and increased the number of chipped samples cemented onto POM implants with zinc oxide. This study could not show any significant impact on the fracture resistance of zirconia when different cements and implant analogs were used.

Prevalence of xerostomia and hyposalivation and their association with quality of life in elderly patients in dependence on dental status and prosthetic rehabilitation: a pilot study.

OBJECTIVES: The aims of this pilot study were to investigate the prevalence of xerostomia and hyposalivation and their impact on quality of life in a cohort of elderly patients including dental status and the character of potential prosthetic restorations as independent variables. METHODS: Patients aged 60 years or older without any objective or subjective need for prosthodontic treatment taking part in a regular recall programme were included in the trial. Quality of life was assessed using the German version of the GOHAI; prevalence and severity of xerostomia was investigated using the shortened version of the Xerostomia Inventory (XI). Stimulated salivary flow rate was determined using a sialometric approach. Dental status and the character of prosthetic restorations (no/fixed restorations and removable but tooth-supported dentures vs. gum-supported dentures) were assessed in a clinical examination by experienced dentists specialized in prosthodontic treatment. RESULTS: A total of 68 patients were included in the trial; a prevalence of xerostomia of 16% and a prevalence of hyposalivation of 31% were identified. The quality of life in the study cohort decreased significantly as a function of xerostomia severity but not salivary flow; moreover, a significant impact of the number of teeth/implants in the upper jaw and the presence of gum-supported dentures in both jaws on GOHAI scores could be identified. CONCLUSIONS: Within the limitations of a pilot study, the results support the assumption that the quality of life in elderly patients is particularly related to their subjective perception of xerostomia. A decline in salivary flow, the dental status and the character of prosthetic restorations appear to play a subordinate role for the quality of life in elderly patients. CLINICAL SIGNIFICANCE: The quality of life in elderly patients may be severely diminished due to an increased subjective perception of dry mouth. Dental treatment should focus on alleviating xerostomia, whereas the impact of dental status and prosthetic restoration appear to be subordinate.

The bacterial adhesion on and the cytotoxicity of various dental cements used for implant-supported fixed restorations.

OBJECTIVE: Bacterial adhesion on and cytotoxicity of eight luting agents used for implant-supported restorations were investigated. MATERIALS AND METHOD: Surface roughness (Ra), surface free energy (SFE) values and three-dimensional images by atomic-force microscopy of circular specimens were determined. Bacterial suspensions of Streptococcus sanguinis and Streptococcus epidermidis were incubated at 37°C for 2 h. Adhering bacteria were examined with fluorescence dye CytoX-Violet, stained with 4',6-diamidino-2-phenylindole (DAPI) and visualized by fluorescence-microscopy. Cytotoxicity-testing was done with WST-1-tests (water soluble tetrazolium). No significant differences, neither with regard to Ra nor regarding SFE were determined. RESULTS: Adherence of S. sanguinis was less on titanium, TempBondNE and TempBond. TempBond, TempBondNE, RelyX Unicem and Implantlink Semi Classic presented low amounts of S. epidermidis. WST-testing showed high cytotoxic potential of Harvard, Aqualox, TempBondNE and TempBond. No combination of low adherent bacteria with low cytotoxicity was found. CONCLUSION: From a biological in-vitro perspective, none of the cements may be recommended for implant-supported restorations.