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Biomedical subjects

H Wagener

Publications and source records attributed to H Wagener.

At least 19 recordsLinked to original sources

Efficacy and tolerability of diclofenac potassium sachets in acute postoperative dental pain: a placebo-controlled, randomised, comparative study vs. diclofenac potassium tablets.

This double-blind, randomised, parallel-group trial compared the analgesic efficacy of single 50 mg doses of diclofenac potassium sachets and tablets with placebo in 184 patients with moderate/severe pain after third molar extraction. The primary efficacy variable was the average pain reduction from baseline during the first 2-h postdose, using a visual analogue scale (VAS). During the first 2-h postdose, sachets and tablets significantly reduced pain (p < 0.05) vs. placebo with an incremental benefit seen for sachets over tablets (p < 0.05). Onset of analgesic effect (VAS) was at 30 min for sachets and 45 min for tablets. Pain reduction vs. placebo (VAS) was maintained for 8 h for sachets and tablets (p < 0.05). VAS-findings were confirmed by pain relief and intensity verbal scale assessments. Fewer patients re-medicated vs. placebo. No safety issues were identified. This study demonstrates that both diclofenac potassium sachets and tablets offer patients suffering from acute pain conditions an effective treatment with incremental analgesic benefits seen for sachets.

Adolescent↗

[Dental injuries due to miniplate osteosynthesis. Classification, treatment management, complications, and prognosis].

BACKGROUND: In spite of a monocortical design, miniplate osteosynthesis can injure dental roots directly as well as damage dental substance indirectly by interrupting the apical blood stream. PURPOSE: The present retrospective study classifies different types of dental root trauma caused by monocortical screws, suggests therapeutic options based on diagnosis, and documents survival probability and prognosis after tooth trauma. PATIENTS AND METHODS: During a period of 11 years, 380 patients with permanent dentition underwent miniplate osteosynthesis for the treatment of mandibular fractures, 29 of whom sustained dental root trauma caused by drilling failure. These patients were clinically and radiographically examined for a follow-up time of not less than 38 months. RESULTS: The 29 patients could be classified into four different types of dental root trauma: 13 pulp injuries above the apical third of the root (type Ia), 6 pulp injuries in the apical third of the root or extradental lesions interrupting the apical blood stream (type Ib), 4 lesions to the central radicular dentin without pulp injury (type II), and 6 lesions to the peripheral radicular dentin and root cementum (type III). Of 13 type Ia injuries, 5 developed apical periodontitis and dilatation of the periodontal space. Therefore one root canal treatment and three apicoectomies were performed. One tooth had to be extracted. Three further type Ia injuries and two type Ib injuries showed root resorptions inducing two root canal treatments. One of six type Ib injuries required root canal treatment because of apical periodontitis. One of four type II injuries caused root resorption not requiring therapy. No relevant, pathological finding could be identified after type III injury. CONCLUSIONS: The type of dental root trauma caused by miniplate osteosynthesis determines therapy, complication rate, and survival of the injured tooth.

Adolescent↗

Atypical expression of cleidocranial dysplasia: clinical and molecular-genetic analysis.

Cleidocranial dysplasia (CCD) and the Rubinstein-Taybi syndrome (RTS) are two rare congenital syndromes that have many clinical signs in common. We present an 18-year-old-patient with untypical CCD expression who was misdiagnosed with RTS at the age of 2 years. An extensive craniofacial examination was carried out with respect to morphological and dental aspects. The molecular-genetic analysis of two underlying genes (CBFA1 and CBP) for CCD and RTS was performed using SSCP, direct sequencing and FISH. While the clinical examination showed uncharacteristic CCD symptoms with some findings common for RTS, the molecular-genetic analysis revealed a missense mutation in the CBFA1 gene, which is considered to be the etiological factor for CCD. Our findings with this patient presented clear evidence for the wide morphologic variety that can be related to a certain gene such as CBFA1. The diagnosis of rare diseases is currently based on the clinical phenomenology of small groups or single cases. The use of molecular-genetic biology extends the horizon of diagnostic and scientific possibilities. In this patient, it allowed us to compare the clinically diagnosis to molecular-genetic data. We conclude that molecular-genetic analysis may be a helpful tool in the differential diagnosis of many congenital diseases such as CCD and RTS.

Adolescent↗

[Precision of computer-assisted systems in profile reconstructive interventions on the face].

In this investigation we compared the precision of different computer-aided systems for positioning osteotomized segments to reconstruct craniofacial asymmetries. The accuracy of a mechanical navigation system, a laser-guided navigation system and the precision of templates moulded on stereolithographic models are compared, using measurements on geometrical objects, anatomical specimens and clinical application. The precision of a mechanical navigation system is 0.5 mm, and a laser-guided system 0.3 mm. The accuracy of a computer and template guided application is 1 mm.

Data Collection↗

[Single lag screw osteosynthesis for management of mandibular angle fractures].

80 patients with 83 fractures of the mandibular angle were treated by lag screw fixation. The screws were placed through a transoral incision with transbuccal trochar instrumentation. No maxillomandibular fixation was used. Complications occurred in 12 fractures (14%), of which 5 (6%) required secondary surgical intervention. In all cases bony union was achieved 6 months postoperatively. Indications and advantages of the technique are discussed.

Adult↗

[Indications and results of transdental fixation with the Wirz Syntacoben screw in frontal tooth reconstruction].

In a one-armed prospective study including 60 patients (27 male, 33 female; age 17-75 years), 109 teeth were treated by means of a screw system made of Syntacoben and Niob according to Wirz. 103 teeth were transfixed successfully: 48% of them were provided with a partial removable denture; 34% were used as a bridge pier; 11% underwent conservative treatment; in 7% prosthetic treatment is planned. The use of the Wirz-System for primary transfixation combines in an ideal way the advantages of endodontic conservation and the ready-made post with the improved stability of the prosthetic pier.

Adolescent↗