PubMed Health⌕ Search

Biomedical subjects

J Kisch

Publications and source records attributed to J Kisch.

14 recordsLinked to original sources
PubMed2001

Fixed mandibular restorations on three early-loaded regular platform Brånemark implants.

BACKGROUND: Originally, the Brånemark System was used as a two-stage surgical procedure. Comparable clinical results have made one-stage and early-loading concepts possible alternatives in the edentulous mandible. From the patient's point of view, the financial aspect of implant treatment is important. In an attempt to decrease financial burden, the reduction of surgical interventions and reduction of the number of implants could be considered. PURPOSE: This prospective multicenter study evaluated (1) the 1- and 3-year success rates of implants loaded within 1 month after one-stage surgery with a fixed 10- to 12-unit bridge on three regular platform Brånemark System implants in the mandible, (2) the outcome of the prosthetic treatment, and (3) the opinion of patients regarding the treatment procedure. MATERIALS AND METHODS: Of 20 patients, 19 received five implants in the mandible, of which three were functionally loaded with the one-stage technique (group 1). The loaded implants were inserted in a tripodal position, one implant in the symphysis and two located anterior of the mental foramen in the bicuspid area. Two additional implants were inserted for safety reasons but were not intended to be included in the restoration. These two additional implants served as either an unloaded one-stage control implant (group 2) or an unloaded control implant installed with the submerged technique (group 3). Immediately after surgery, the implants were loaded with a relined denture. The patients received a 10- to 12-unit prosthetic reconstruction an average 31 days (range, 4-53 d) after surgery. Implant stability was clinically checked at 3, 12, and 36 months. Radiographs were taken at corresponding follow-up visits to calculate bone-to-implant level and marginal bone resorption. RESULTS: Six of 60 functionally loaded implants (10%) and 3 of 20 prostheses (15%) failed within the first year. The cumulative implant failure rate in group 1, both after 1 and after 3 years, was 9.5%. No implant failure occurred in the control groups 2 and 3. The average marginal bone level measured at 1 and 3 years was 1.6 mm (SD = 0.8 mm) and 2.1 mm (SD = 0.2 mm), respectively, for group 1; 1.5 mm (SD = 1.3 mm) and 2.4 mm (SD = 0.6 mm), respectively, for group 2; 0.8 mm (SD = 1.4 mm) and 0.7 mm (SD = 0.9 mm), respectively, for group 3. CONCLUSIONS: The results of treatment using three regular platform Brånemark System implants supporting a fixed mandibular arch reconstruction were less favorable than the outcome that can be expected with a standard four- to six-implant with one-stage surgery.

Adult↗
PubMed2000

Operant conditioning of antennal muscle activity in the honey bee (Apis mellifera L.).

Antennal movements of the honey bee can be conditioned operantly under laboratory conditions. Using this behavioural paradigm we have developed a preparation in which the activity of a single antennal muscle has been operantly conditioned. This muscle, the fast flagellum flexor muscle, is innervated by an identified motoneuron whose action potentials correlate 1:1 with the muscle potentials. The activity of the fast flagellum flexor muscle was recorded extracellularly from the scapus of the antenna. The animal was rewarded with a drop of sucrose solution whenever the muscle activity exceeded a defined reward threshold. The reward threshold was one standard deviation above the mean spontaneous frequency prior to conditioning. After ten conditioning trials, the frequency of the muscle potentials had increased significantly compared to the spontaneous frequency. The conditioned changes of frequency were observed for 30 min after conditioning. No significant changes of the frequency were found in the yoke control group. The firing pattern of the muscle potentials did not change significantly after conditioning or feeding. Fixing the antennal joints reduces or abolishes associative operant conditioning. The conditioned changes of the frequency of muscle potentials in the freely moving antenna are directly comparable to the behavioural changes during operant conditioning.

Animal Structures↗
PubMed1999

Operant conditioning of antennal movements in the honey bee.

An operant learning protocol was developed for honeybees that are fixed in small tubes. The bees had to touch one or two small silver plates within the range of one antenna. The contacts of the antenna with the silver plates were registered electronically. Three conditioning protocols were analysed. In the first series the conditioned increase of the contact frequency was tested. The animals could touch one plate and received a reward (a small drop of sucrose) whenever the instantaneous frequency at this plate was more than one or two standard deviations above the spontaneous frequency. After conditioning the bees showed a significant increase of the contact frequency. No significant changes were found in a group of yoked controls. In the second series differential conditioning was tested. The animals could touch two silver plates. The spontaneous behaviour was measured and the animals received the reward upon touching the plate with the lower spontaneous frequency. The rewards were only applied whenever the instantaneous frequency exceeded a defined threshold. After ten conditioning trials the animals showed a significant increase in contact frequency for the conditioned plate compared to spontaneous behaviour. No significant changes were found in a group of yoked controls. In the third series reversal learning was tested. The animals were able to touch two silver plates. They were first conditioned to touch the plate which had the lower spontaneous contact frequency. After these conditioning trials they were tested for 10 min and subsequently conditioned to the alternative plate. The experiments demonstrated significant reversal learning compared to yoked controls. This new operant conditioning paradigm for the bee offers the possibility to analyse at the physiological level the mechanisms underlying different forms of learning in this insect.

Animals↗
PubMed1998

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis.

A double-blind, randomised, 6-month clinical trial with parallel group design in 149 patients with gingivitis was conducted to study the efficacy and safety of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash) used for partly supervised mouthrinsing in comparison with chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK) and placebo as an addition to normal oral hygiene. Assessments of efficacy were performed using the plaque index and bleeding on probing (BOP). Delmopinol showed 22% lower plaque index scores than placebo after 3 months (p<0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% (p<0.001) and 38% (p<0.001) after 3 and 6 months, respectively. Bleeding on probing was reduced for delmopinol in comparison with placebo by 11% after 3 months and by 18% (p<0.05) after 6 months. For chlorhexidine the corresponding figures were 18% (p<0.01) and 22% (p<0.01) after 3 and 6 months, respectively. While chlorhexidine showed greater plaque reduction than delmopinol (p<0.01 at 6 months), no statistically significant difference was reached between these two solutions regarding BOP. Both active solutions showed an increased amount of dental calculus in comparison with placebo. A transient anaesthetic sensation in the oral mucosa and taste affection were commonly reported adverse events in both the delmopinol and the chlorhexidine groups. The number of patients withdrawn from treatment due to adverse events or lack of cooperation was 7 in the chlorhexidine group, 4 in the placebo group and 1 in the delmopinol group. The results showed that rinsing with either 0.2% delmopinol hydrochloride or 0.2% chlorhexidine digluconate twice daily for 60 secs for 6 months results in less plaque formation and gingivitis than rinsing with placebo. Mouthrinsing with the 0.2% delmopinol hydrochloride solution was well accepted in this study.

Adult↗
PubMed1994

New dimensions in behavioral health/primary care integration.

The case is made for the integration of primary care and behavioral health services in the HMO. Key features of a successfully integrated behavioral health service are offered, along with brief reports of integration efforts at a number of HMOs across the United States. The author believes that better value and cost efficiencies result from integration.

Continuity of Patient Care↗
PubMed1992

3 regimens of topical metronidazole compared with subgingival scaling on periodontal pathology in adults.

This report presents the findings from an open randomized multicentre clinical trial designed to compare the clinical efficacy of scaling with application of 3 different preparations/dose frequencies of topical metronidazole in the treatment of adult periodontitis. The 4 treatments were: (A) metronidazole 25% dental gel administered 1 x a week for 2 weeks; (B) metronidazole 15% dental gel applied 1 x a week for 2 weeks; (C) metronidazole 15% dental gel applied 2 x a week for 2 weeks; (D) subgingival scaling, performed 1 x only. A split mouth design was used. Patients were included in the study if they had at least 1 tooth in each quadrant with a pocket depth > or = 5 mm in at least 1 of 4 sites. A total of 61 patients from 4 centres were entered into the study. The efficacy parameters were probing pocket depth and bleeding on probing. Follow-up visits for recording of clinical efficacy were made at 2, 4, 6 and 12 weeks after the end of metronidazole treatment. All 3 antibiotic treatments (A, B, C) reduced the symptoms of periodontal pathology and yielded results comparable to those seen after subgingival scaling (D). When using a topical drug therapy, it seems important to use a preparation that requires as few applications as possible. The best candidate for drug therapy would therefore be treatment (A) metronidazole 25% applied 1 x a week for 2 weeks.

Adult↗
PubMed1992

Clinical responses to subgingival application of a metronidazole 25% gel compared to the effect of subgingival scaling in adult periodontitis.

A newly developed metronidazole 25% dental gel was compared with subgingival scaling in the treatment of adult periodontitis. 206 patients in 9 centres participated in the study. Probing pocket depth (PPD) and bleeding on probing (BOP) were recorded before treatment and 2, 6, 12, 18, and 24 weeks after the treatment. All patients had at least 1 tooth in each quadrant with a PPD of 5 mm or more. The treatments consisted of 2 applications of dental gel (days 0 and 7) in 2 randomly selected quadrants (split mouth design) and 2 sessions of subgingival scaling (1 quadrant on day 0, and 1 quadrant on day 7). Instruction in oral hygiene was given 2 weeks after completed treatment. The average PPD and the average frequency of BOP were calculated over all sites with initial PPD of 5 mm or more. PPD and BOP were thus, at each examination, calculated from the same sites. The mean PPD was 5.9 mm before gel application and 5.8 mm before scaling (p = 0.31). BOP was 88% in both treatment groups. 24 weeks after the treatment, PPD and BOP were significantly reduced in both groups and for both parameters (p < 0.01). PPD was reduced by 1.3 mm after gel application and 1.5 mm after scaling; BOP was reduced by 32% and 39%, respectively. The difference between the treatments was statistically significantly, but considered as clinically unimportant.

Adult↗
PubMed1992

Utilization of mental health services. Attrition versus aggregation.

Mental health services are utilized in the context of opposing trends of decline and accumulation in caseload. A rapid attrition in frequency of contact is counterbalanced by a slower aggregation of cases failing to reach termination. These opposite, simultaneous forces mean that a mental health service may be meeting its goal of containing the duration of treatment while its practitioners are contending with a sizable caseload resistant to closure. This phenomenon is empirically described.

Appointments and Schedules↗
PubMed1991

Autotransplantation of third molars as treatment in advanced periodontal disease.

The aim of this study was to investigate the prognosis of replacing molars with advanced periodontitis by autotransplanted fully developed third molars. The patient sample consisted of 18 subjects, 24-58 years of age. The patients selected had at least 1 molar with advanced periodontal tissue destruction. After extraction of the diseased molar, autotransplantation of a third molar was immediately performed. After a splinting and healing period of 2-3 weeks, endodontic treatment was carried out. The follow-up included recordings of the clinical parameters, probing periodontal pocket depth, probing attachment level, percussion sound, and mobility. Radiographs were taken immediately after the surgical procedure, after 6 months, 1 year, and thereafter annually. The results of this study indicate that autotransplantation may be an alternative treatment procedure for molars with advanced periodontal disease.

Adult↗
PubMed1986

Longitudinal observation of "unattached," mobile gingival areas.

Facial gingival surfaces over cuspids and bicuspids in 20 patients were monitored for 5 years to evaluate the importance of attached gingiva in the maintenance of a stable periodontium. 43 surfaces "at risk" were compared to 36 "non-risk" surfaces within these patients. Surfaces "at risk" had to meet the following 3 criteria as established by both of 2 independent examiners: width of keratinized gingiva less than or equal to 1.0 mm; absence of attached gingiva; mobility of the gingival margin. During the 5 years of observation, "non-risk" surfaces showed a trend toward decrease in mean width of keratinized gingiva, while this measurement remained unchanged for the surfaces "at risk" Probing depths remained unaltered for both groups. A trend toward gingival recession and loss of probing attachment was observed for both "risk" and "non-risk" surfaces. Thus, this study failed to demonstrate that "unattached" and mobile facial gingival surfaces are more susceptible to periodontal breakdown than "attached" surfaces.

Adult↗
PubMed1981

In-patient community meetings: problems and purposes.

The role of the in-patient community meeting is discussed in relation to the general difficulty of attributing specific effectiveness to any type of therapeutic activity on an in-patient service. Close scrutiny of such units demonstrates that staff and patients are composed of several heterogeneous subgroups, not all of whom share common attitudes and values or benefit from similar activities. Within this framework the major problems as well as functions of the community meeting are discussed. Specific questions which await investigation with clinical research are elaborated.

Attitude of Health Personnel↗
PubMedDate not supplied

Psychotherapy in the HMO: clinical perspectives.

Tensions between expectations and possibilities in providing mental health services are more evident in closed systems like an HMO. These stresses have an impact on clinical providers of psychotherapy. Because further contact cannot substitute for lack of clinical success, special demand is placed on the clinician to achieve an alliance and then reach closure. The situation of the psychotherapist in the HMO is discussed.

Health Maintenance Organizations↗