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Biomedical subjects

J W Verhoeven

Publications and source records attributed to J W Verhoeven.

At least 19 recordsLinked to original sources
PubMed2002

[Onlay grafts in combination with endosseous implants in severe mandibular atrophy. A prospective radiological study].

The placement of endosseous implants in combination with iliac crest onlay grafting of the anterior mandible is one of the treatment modalities for extreme atrophy of the mandible. The remodelling of these onlay grafts was studied using standardized extraoral oblique lateral cephalometric radiographs (OLCRs). A group of 8 patients was used in this prospective study. The measurements obtained from the OLCRs indicated the existence of the following stages in the process of remodelling of the bone grafts: 1. decrease in thickness and radiographic density of the (upper) cortex of the graft, predominantly during the first half year after grafting; 2. no significant changes in the radiographic density of the upper spongeous part of the graft; 3. a mean decrease of approximately 25% in the overall thickness of the graft, particularly during the first half year; and 4. an increase in the radiographic density of the lower part of the spongeous bone in the second half year after grafting. It is concluded that the remodelling of the graft has a predictable pattern in time. Densitometric measurement using standardized OLCRs can be a useful tool to evaluate quantitative changes of bone grafts to the mandible. The treatment described can be used on very strict indications only.

Absorptiometry, Photon↗
PubMed2001

The use of the transmandibular implant system in extreme atrophy of the mandible; a retrospective study of the results in two different hospital situations.

This retrospective study aims to investigate and compare the results obtained with the transmandibular implant (TMI) in two different hospital situations. Group I were patients treated in a teaching hospital since 1984 by a varying group of surgeons and prosthodontists with a varying degree of experience with the TMI. Group II were patients treated in 1993 and 1994 by experienced surgeons and prosthodontists in the hospital where the TMI was originally developed. In group I, a relatively high frequency of reversible (45.4%) and irreversible--i.e. implant loss--(15.2%) complications occurred. In group II, no implants were lost and reversible complications were reported in 10.8% of the patients. In general, the patients of both groups were quite satisfied with the result of the treatment. In both groups, limited bone loss around the implant posts could be observed. An increase in the height of the mandibular bone distal of the lateral posts was frequently observed, especially in group II. It is concluded that both very favourable and less favourable results can be obtained with the TMI. In this study the best results are found in a highly specialized TMI centre, where patients are treated--with only uncompromised implant-posts--by a small group of experienced surgeons and prosthodontics with accurate application of the existing guidelines.

Atrophy↗
PubMed2000

Oblique lateral cephalometric radiographs of the mandible in implantology: usefulness and accuracy of the technique in height measurements of mandibular bone in vivo.

Various radiographic techniques are used for longitudinal studies of changes in the height of the mandible with implants. Advantages and disadvantages of panoramic radiographs, lateral cephalometric radiographs, periapical films and modern CT- and MRI-techniques are briefly discussed. In this study, the usefulness of a conventional radiographic technique for measuring the height of the mandible, i.e. oblique lateral cephalometric radiography (OLCR) is evaluated in vivo. In 16 patients with permucosal implants in the anterior mandible OLCRs were repeated the same day. The mean total error for the radiographic procedure and analysis was 0.38 mm. The intra-observer error for the determination of the mandibular height by means of the image analysis procedure was 0.16 mm (analysis error). In 12 other patients pairs of radiographs of the same area of the mandible were made using both a "standard" horizontal X-ray beam direction and an individually determined "optimal" horizontal X-ray beam direction; the maximum difference between these two angulations was plus or minus 7.5 degrees. The effect of this different angulation on the height measurements is comparable to the above-mentioned total error of the measurement procedure (positioning error). An accurate positioning of the patient seems important for reliable measurements. The described radiographic (OLCR) and analysis (IBAS) technique can be used relatively simply for clinical studies. The described methods appear to be useful for measuring the mandibular height in longitudinal studies in patients with or without implants.

Cephalometry↗
PubMed2000

Oblique lateral cephalometric radiographs of the mandible in implantology: usefulness and reproducibility of the technique in quantitative densitometric measurements of the mandible in vivo.

In the literature intraoral periapical radiographs are commonly used for densitometric measurements of the mandible with implants. These films give detailed information of the implant and the surrounding bone. However, in extreme mandibular atrophy it can be difficult to obtain intraoral radiographs of adequate diagnostic quality. Extraoral Oblique Lateral Cephalometric Radiographs (OLCRs) can then be the alternative: reproducible images of large parts of the mandible can be obtained. In vitro, the results of densitometry using periapical films and OLCRs were shown to be similar. The present study aims to determine the measurement error of densitometry with OLCRs in vivo. In 16 patients (group I) with atrophic mandible and implants, duplicate OLCRs of one side of the jaw were obtained. The error of measurement for the densitometric measurements of the mandibular bone was 5.5%. The use of a specially developed correction program to compensate for undesired variations in the projection of the soft tissues of the face (tongue, lips, cheek and neck) on the radiographs resulted in a 40% reduction of that measurement error to 3.5%. This remaining error is mainly brought about by an imperfect repositioning of the patient when the duplicate OLCRs are obtained. The error caused by the image acquisition, processing and measurement is less than 1%. Deliberate variation up to 7.5 degrees of the horizontal angle wherein the OLCRs are made, results in a large error of measurement of 13.5% (group II: 17 patients). To reduce this variation the additional soft tissue correction program is unsuitable. It is concluded from this study that the described radiographic and image analysis technique is a promising tool for prospective densitometric studies of the mandible with or without implants. Especially in mandibles with bone grafts and implants, substantial changes in the graft can occur. The described technique may be particularly valuable in analyzing these changes.

Aluminum↗
PubMed2000

Onlay grafts in combination with endosseous implants in severe mandibular atrophy: one year results of a prospective, quantitative radiological study.

In taking an overall view of the radiographs made of patients that underwent simultaneous onlay-grafting and implant placement in the anterior mandible, changes are seen in the grafts. The impression arose that a number of stages could be distinguished in this process of remodelling of the graft. The purpose of the present study was to objectivate the existence of those stages in the first year after bone-grafting by densitometric and height measurements of the onlay grafts using standardized extraoral radiographs (OLCR) and densitometric analysis in a group of 8 patients. OLCRs were taken at regular intervals in the first year after surgery. The measurements were performed in three fixed fields, both ventrally and dorsally of each implant. Generally the densitometric measurement fields were located at the (upper) cortex, the upper spongiosa and the lower spongiosa of the onlay graft. The OLCRs were also used for measurements of the height of the complete graft and of the thickness of the cortex of the graft, using a gauged caliper. The results indicate the following remodelling of the structure of the onlay grafts: 1) decrease in the thickness and the radiographic density of the (upper) cortex of the onlay graft predominantly in the first 6-month period; 2) no significant changes in the radiographic density of the upper spongeous part of the graft; 3) a decrease of approximately 25% in the overall height of the graft, particularly during the first 6-month period; 4) an increase in the radiographic density of the lower part of the spongeous bone in the second 6-month period. It is concluded that the remodelling of the graft has a predictable pattern in time: the first half year being dominated by bone resorption, mainly confined to the cortex of the graft, whereas the second half year is characterized by an increase in bone density in the (remaining) cortex as well as the lower spongeous parts of the graft.

Absorptiometry, Photon↗
PubMed2000

Reliability of some clinical parameters of evaluation in implant dentistry.

Clinical tests that are commonly used to evaluate tissues surrounding natural teeth are also used in implant dentistry. It is unclear if they are equally valid and reflect the condition of the bone surrounding an implant reliably. This study evaluates the use of a plaque index, a gingiva index, the assessment of a probing depth and the Periotest value and relates the findings to the image on a radiograph in 16 patients, involving 32 IMZ implants. All four clinical tests showed poor sensitivity and, in general, only fair specificity when observations from the image on the radiograph were interpreted as the 'golden standard' for the presence or absence of pathology adjacent to the implant. Frequently, based on any clinical parameter, disease was not diagnosed, while the radiograph did show pathological loss of bone at the bone-implant contact area. It is concluded that the aforementioned parameters are unreliable and unfit for clinical evaluation in implant dentistry. Radiographs are needed to evaluate critical marginal bone changes surrounding dental implants.

Adult↗
PubMed1998

Trans/cis (Z/E) photoisomerization of the chromophore of photoactive yellow protein is not a prerequisite for the initiation of the photocycle of this photoreceptor protein.

The chromophore of photoactive yellow protein (PYP) (i.e., 4-hydroxycinnamic acid) has been replaced by an analogue with a triple bond, rather than a double bond (by using 4-hydroxyphenylpropiolic acid in the reconstitution, yielding hybrid I) and by a "locked" chromophore (through reconstitution with 7-hydroxycoumarin-3-carboxylic acid, in which a covalent bridge is present across the vinyl bond, resulting in hybrid II). These hybrids absorb maximally at 464 and 443 nm, respectively, which indicates that in both hybrids the deprotonated chromophore does fit into the chromophore-binding pocket. Because the triple bond cannot undergo cis/trans (or E/Z) photoisomerization and because of the presence of the lock across the vinyl double bond in hybrid II, it was predicted that these two hybrids would not be able to photocycle. Surprisingly, both are able. We have demonstrated this ability by making use of transient absorption, low-temperature absorption, and Fourier-transform infrared (FTIR) spectroscopy. Both hybrids, upon photoexcitation, display authentic photocycle signals in terms of a red-shifted intermediate; hybrid I, in addition, goes through a blue-shifted-like intermediate state, with very slow kinetics. We interpret these results as further evidence that rotation of the carbonyl group of the thioester-linked chromophore of PYP, proposed in a previous FTIR study and visualized in recent time-resolved x-ray diffraction experiments, is of critical importance for photoactivation of PYP.

Bacterial Proteins↗
PubMed1998

Densitometric measurements of the mandible: accuracy and validity of intraoral versus extraoral radiographical techniques in an in vitro study.

In this study a comparison is made between intraoral and extraoral radiographical techniques for quantitative measurements of bone density in the edentulous mandible. A phantom model, composed of a dry mandible surrounded by a soft tissue substitute was used. Radiographs were made of aluminium implants of known volumes. Intra- and extraorally placed reference wedges of aluminium or a combination of aluminium and plexiglas were used for the measurement of the aluminium volume of the above-mentioned implants and compared with the real volume. The IBAS image analysis system was used for image processing and measurements. A systematic deficit in the measured volume of 15 to 29% was found. This error was irrespective of the radiographical technique and indicates a constant underestimation of the aluminium volumes. The differential influence of the secondary radiation on the images of the jaw and the wedge is proposed to be a possible cause of this constant underestimation. The intraoral and extraoral techniques do not display significant statistical differences in the levels of validity or accuracy. Obtaining serial intraoral radiographs of adequate quality in the atrophic edentulous mandible can be problematic. It is concluded from this in vitro study that in these cases Oblique Lateral Cephalometric Radiographs may provide a valuable alternative for quantitative image analysis.

Absorptiometry, Photon↗
PubMed1998

[Reliability of some clinical parameters in implant dentistry].

OBJECTIVE: This study evaluates if clinical tests that are commonly used to evaluate tissues surrounding natural teeth are equally valid in clinical evaluation of dental implants. DESIGN: A retrospective clinical study. SETTING: Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care of the University of Utrecht. METHOD: The use of a plaque index, a gingival index, probing depth measurements and the Periotest was evaluated by relating the findings to the image on a radiograph in 16 patients, involving 32 IMZ implants. RESULTS: The four clinical tests show poor sensitivity and in general only fair specificity. CONCLUSION: The parameters are unreliable and unfit for clinical evaluation in implant dentistry during regular recall visits. Radiographs are needed to evaluate the condition of a dental implant and to detect critical marginal bone changes surrounding dental implants at an early stage.

Dental Implants↗
PubMed1997

The combined use of endosteal implants and iliac crest onlay grafts in the severely atrophic mandible: a longitudinal study.

Thirteen patients, who received an onlay bone graft augmentation to their severely atrophic mandible in combination with a simultaneous implant insertion, were studied prospectively. A reproducible method that allowed for accurate assessment of graft resorption, consisting of lateral and oblique-lateral cephalometric radiographs in combination with an image analysis system, was used to assess the resorption rate in all patients and between subgroups of patients, according to selected patient and treatment characteristics. Thirty implants were placed, none of which were lost, and all patients expressed satisfaction after a mean observation period of 877 days. A mean resorption rate of 36% of the grafted bone height occurred, mainly during the first year and with some degree of individual variance. After three years the resorption had virtually stopped. No statistically significant differences between any of the subgroups of patients could be distinguished. Peri-implantitis was found around eight implants in seven patients. It is concluded that the described surgical technique should be used only if there are stringent indications.

Aged↗
PubMed1996

Spectral tuning, fluorescence, and photoactivity in hybrids of photoactive yellow protein, reconstituted with native or modified chromophores.

Photoactive yellow proteins (PYPs) constitute a new class of eubacterial photoreceptors, containing a deprotonated thiol ester-linked 4-hydroxycinnamic acid chromophore. Interactions with the protein dramatically change the (photo)chemical properties of this cofactor. Here we describe the reconstitution of apoPYP with anhydrides of various chromophore analogues. The resulting hybrid PYPs, their acid-denatured states, and corresponding model compounds were characterized with respect to their absorption spectrum, pK for chromophore deprotonation, fluorescence quantum yield, and Stokes shift. Three factors contributing to the tuning of the absorption of the hybrid PYPs were quantified: (i) thiol ester bond formation, (ii) chromophore deprotonation, and (iii) specific chromophore-protein interactions. Analogues lacking the 4-hydroxy substituent lack both contributions (chromophore deprotonation and specific chromophore-protein interactions), confirming the importance of this substituent in optical tuning of PYP. Hydroxy and methoxy substituents in the 3- and/or 5-position do not disrupt strong interactions with the protein but increase their pK for protonation and the fluorescence quantum yield. Both deprotonation and binding to apoPYP strongly decrease the Stokes shift of chromophore fluorescence. Therefore, coupling of the chromophore to the apoprotein not only reduces the energy gap between its ground and excited state but also the extent of reorganization between these two states. Two of the PYP hybrids show photoactivity comparable with native PYP, although with retarded recovery of the initial state.

Bacterial Proteins↗
PubMed1996

Influence of the triplet excited state on the photobleaching kinetics of fluorescein in microscopy.

The investigation in this report aimed at providing photophysical evidence that the long-lived triplet excited state plays an important role in the non-single-exponential photobleaching kinetics of fluorescein in microscopy. Experiments demonstrated that a thiol-containing reducing agent, mercaptoethylamine (MEA or cysteamine), was the most effective, among other commonly known radical quenchers or singlet oxygen scavengers, in suppressing photobleaching of fluorescein while not reducing the fluorescence quantum yield. The protective effect against photobleaching of fluorescein in the bound state was also found in microscopy. The antibleaching effect of MEA let to a series of experiments using time-delayed fluorescence spectroscopy and nanosecond laser flash photolysis. The combined results showed that MEA directly quenched the triplet excited state and the semioxidized radical form of fluorescein without affecting the singlet excited state. The triplet lifetime of fluorescein was reduced upon adding MEA. It demonstrated that photobleaching of fluorescein in microscopy is related to the accumulation of the long-lived triplet excited state of fluorescein and that by quenching the triplet excited state and the semioxidized form of fluorescein to restore the dye molecules to the singlet ground state, photobleaching can be reduced.

Biophysical Phenomena↗
PubMed1984

Choice of contrast medium in sialography.

Contrast media used for sialography were originally developed for other medical applications. Therefore, it was considered desirable to investigate the properties of these substances for use in sialography. Eleven radiopaque substances were selected, and their properties for sialography were studied. An in vitro study was made to determine their contrast qualities and their rate of evacuation after the sialographic examination. In animal experiments the possible harmful effects of the media on salivary gland tissues were studied. Moreover, the effects of the radiopaque material on the extraglandular tissues--which are important in understanding the consequences of spilling into these tissues--were investigated. The results of this study were compared with data from the literature. Conray 80, Amipaque 440, Lipiodol UF, Myodil, and Duroliopaque appear to be the media most suited for sialography, provided glandular overfilling is avoided. A prolonged clinical study is advised for a further selection from these agents.

Animals↗
PubMed1979

The length of teeth. A statistical analysis of the differences in length of human teeth for radiologic purposes.

Intraoral radiograms can be made according to the long tube paralleling technique utilizing aiming devices. An important factor in the design of these instruments is the length of the teeth to be radiographed. Reliable data regarding the length of the teeth in the different regions of the mouth are not available. Information on the length of teeth was therefore collected by measuring 1,400 extracted teeth. A statistical analysis of the data finally resulted for each region of the mouth and for both sexes in length value which could be used for the design of aiming devices.

Bicuspid↗
PubMed1979

Factors influencing the design of aiming devices for intraoral radiography and their practical application.

Intraoral roentgenograms can be made according to the long-tube paralleling technique utilizing aiming devices. These instruments consist of a bite block, an indicator rod, and a collimator plate. For the position of the film in relation to the bite block surface, the following data are decisive and therefore studied: the length of the teeth to be radiographed, the enlargement as a result of the divergence of the x-ray beam, and the periapical area necessary for the interpretation and mounting of the roentgenograms. As a result, the bite blocks of the instruments were provided with three vertical steps to permit different film positions needed for the specific situation in the different regions of the mouth. The use of the correct film positions results in roentgenograms with a high diagnostic value. In order to reduce the patients radiation dose the aiming devices include a collimator plate. A description is given of the data used for the design of the plate.

Dental Instruments↗