Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)

2006-04-01 / 2. szám

FOGORVOSI SZEMLE ■ 99. évf. 2. sz. 2006. Results: In all of our cases fine granular reaction was detected for CLDN1, CLDN4 and CLDN7 confined to the cellular membranes of the suprabasal epithelial cells. How­ever, CLDN1 exhibited the strongest and most extended expression in the prickle and granular cell layers whereas CLDN 7 and CLDN 4 expression was much weaker, restricted to the stratum spinosum or to the lower sheets of the prickle cell layer respectively. Interestingly, the stratum basale failed to express CLDN1 CLDN4 and CLDN7. CLDN2 showed coarse, granular intracytoplasmatic reaction which was most pronounced in the basal and suprabasal layers with subsequent decreased intensity towards the upper sheets of epthelia. Finally, CLDN3 was not detectable. Conclusion: The individual CLDNs exhibited character­istic distribution and expression pattern in normal human gin­giva, suggesting that different claudins may play differential role to maintain epithelial integrity. DR. ZS. BUDAI * 4 Humandent Bt., Budapest COMPARISON OF THE THERAPEUTIC EFFECTS OF RADIO AND ELECTRIC SURGERY DEVICES Introduction: Radio surgery devices have recently evolved from the family of electric cauters. By using radio surgery devices, we take advantage of the therapeutic effects of al­ternating current in the MHz frequency, i.e. radio-frequency range. We believe it is important that dentists clearly under­stand the physical and electric principles that distinguish this new technique from the other similar approaches. Material and method: We have collected international and Hungarian research results in physics and electric sciences that clearly and, as far as clinical practice is concerned, de­cisively support the statement that the therapeutic current of 4 MHz represents a significantly better quality in the execution of oral surgery interventions. During the use of radio surgery devices it is the living tissue itself that represents the true impedance. During therapeutic intervention the heat forming at the end of the electrode in function as a result of the high current density will have a cutting and coagulation effect. By increasing the frequency, the tissue distribution of the cur­rent positively changes with respect to the therapeutic effect. As a consequence of the so called SKIN-effect, the high frequency electricity is concentrated on the outer surface of the conducting material and, as the frequency is raised fur­ther, the current concentrates into an even thinner layer. In such a way it is possible to minimize the destruction zone. The range of 4 MHz is ideal to have the maximum success expected: 1. It allows extremely precise dosing of energy, which is a prerequisite for the practice of minimally invasive surgery. 2. This dosing becomes highly independent of external circumstances, and it is exclusively determined by the type of tissue to be cut. 3. In case of an optimal adjustment, we are also capable of cutting tissue according to layers. 4. Carbonisation of tissues cannot be observed even at extreme conditions. 5. We can also be prepared to the impedance of some­times unavoidable “wet” (blood, saliva) conditions of the oral cavity. 6. During our interventions, the expected amount of bleeding is approximately one third of the bleeding with traditional surgery procedures. 7. Delayed tissue shrinking is hardly ever experienced, the regeneration is expected to be rapid and undisturbed (per primam healing in cases of lobe formation). Taking account of the various indications, we attempt to de­monstrate the effects, uses, and potential complications of radio surgery and electric surgery interventions. Results: Several lines of histological examinations and clinical experiences support that radio surgery can be viewed as almost the exclusive solution as minimally invasive therapy in regions hard to operate and in proximal and retro molar areas, avoiding the frequently encountered complications of electric surgery. Conclusions: It is extremely difficult, almost impossible to indicate effective therapy and achieve a result free of com­plications without knowing the exact effectivity parameters, indications, and limitations of our device. In addition to the above, we must not forget the special anatomical and histo­logical circumstances of the oral cavity. Thus, it becomes clear that the oral surgery adaptation of dermatology or smaller general surgery devices is not sufficient, instead, it is desirable to develop a device explicitly calibrated to the target area that guarantees optimal intervention. DR. B. CZINKÓCZKY, DR. P. HERMANN, DR. J. GERLE Semmelweis University, Faculty of Dentistry,Training Unit, Budapest LOCAL ANTIBIOTICS IN THE FIELD OF DENTAL IMPLANTOLOGY Introduction: Routine use of antibiotics in the field of dental implantology and ambulant oral surgery continues to be con­troversial. In subsequent years there were many studies, which varied widely and often produced different conclusions of advant­ages and disadvantages. Some recommended the routine use of antibiotics, others did not necessiate utilization in every-day practice. Recommendations for the use vary according to clinical outcomes of different studies. There is agreement about mini­­mazing the duration for antibiotic treatment because of sys­temic side effects. Prophylactic use of the optimal local anti­biotics might be a solution. Material and methods: In a 6-month period 50 patients were treated using local antibiotic Periofilm to monitor changes after implant surgery. Medical history of all patients enrolled in the study was suitable to perform ambulant surgery. Patients did not have any other medical conditions that contraindicated the use of systemic or local antibiotic treatment. In case of 30 patients with penicillin allergy or when a long and/or difficult surgical procedure has been performed, postoperative systemic antibiotics were utilized. After formal consent data were col­lected from standardized questionnaires on postoperative pain,

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