Mombelli A, Van Oosten MAC, Schiirch E, Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987: 2: 145-151. Abstract -In this study the microbiota associated with oral endosteal titanium hollow cylinder implants (ITI) was studied using microscopic, immunochemical and cultural methods. Samples from 5 edentulous patients with successfully incorporated implants serving as abutments for overdentures for more than one year were compared with samples from 7 patients with clinically failing implants. Unsuccessful sites were characterized by pocket probing depths of 6 mm or more, suppuration and visible loss of alveolar bone around the implant as visualized on radiographs. These sites harbored a complex microbiota with a large proportion of Gram-negative anaerobic rods. Black-pigmented Bacteroides and Fusobacterium spp. were regularly found. Spirochetes, fusiform bacteria as well as motile and curved rods were a common feature in the darkfield microscopic specimens of these sites. Control sites in the same patients harbored small amounts of bacteria. The predominant morphotype was coccoid cells. Spirochetes were not present, fusiform bacteria, motile and curved rods were found infrequently and in low numbers. The microbiota in control sites in unsuccessful patients and in site in successful patients were very similar. On the basis of these results, it is suggested that "periimplaiuitis" be regarded as a site specific infection which yields many features in common with chronic adult periodontitis.

The Pathological Narcissism Inventory (PNI) is a multidimensional measure for assessing grandiose and vulnerable features in narcissistic pathology. The aim of the present research was to construct and validate a German translation of the PNI and to provide further information on the PNI's nomological net. Findings from a first study confirm the psychometric soundness of the PNI and replicate its seven-factor first-order structure. A second-order structure was also supported but with several equivalent models. A second study investigating associations with a broad range of measures ( DSM Axis I and II constructs, emotions, personality traits, interpersonal and dysfunctional behaviors, and well-being) supported the concurrent validity of the PNI. Discriminant validity with the Narcissistic Personality Inventory was also shown. Finally, in a third study an extension in a clinical inpatient sample provided further evidence that the PNI is a useful tool to assess the more pathological end of narcissism.

Empirical methods have been found to be superior to clinical judgment for the purpose of correctly identifying patients at risk for treatment failure and, hence, to enhance psychotherapy outcomes. The development and evaluation of an empirical approach aimed at supporting clinical decisions during the course of psychotherapy is described. The tool provides predictions based on a patient-specific sampling strategy called the nearest neighbors method and on growth curve approaches to model an expected treatment course for each patient. Using session-by-session data from an outpatient center in the US (N = 4365), this new empirically derived decision model was evaluated and compared with a clinically based approach loosely based on an adaptation of clinically significant change concepts. The empirically derived decision system was found to be superior to the rational clinically based one in almost all measures of prediction accuracy, indicating its potential to identify patients at risk for treatment failure.

Zusammenfassung. Im Rahmen der sich in den letzten Jahren immer stärker etablierenden Wissenschaftler-Praktiker-Netzwerke und Qualitätssicherungsstudien in der Psychotherapie und Psychiatrie wird der Einsatz von ökonomischen, aber multidimensionalen und veränderungssensitiven klinischen Messinstrumenten zur Verlaufs- und Ergebnismessung therapeutischer Behandlungen immer wichtiger. In der vorliegenden Arbeit wird die Entwicklung von Kurzfragebögen vier gängiger Messinstrumente (der Symptom-Checkliste, SCL-90-R; dem Emotionalitätsinventar, EMI; dem Inventar Interpersonaler Probleme, IIP und dem Inkongruenzfragebogen, INK) sowie die Validität, Reliabilität und Veränderungssensitivität dieser Kurzfragebögen anhand einer Stichprobe der Allgemeinbevölkerung (N = 436), einer Stichprobe ambulanter Psychotherapiepatienten (N = 169) sowie einer Stichprobe von Patienten in stationärer Psychotherapie (N = 134) dargestellt. Die psychometrischen Eigenschaften dieser Kurzformen sowie ein daraus generierter auf 43 Items beruhender Gesamtwert für die allgemeine psychische Beeinträchtigung erlauben den kombinierten Einsatz dieser Instrumente für eine kontinuierliche und ökonomische Erhebung des therapeutischen Fortschritts.

The aim of the present investigation was to evaluate the oral hygiene habits and the periodontal conditions of a group of cleft lip, alveolus and palate patients at the end of a longitudinal multidisciplinary treatment. From a total of 120 patients who had been supervised at the University of Berne, Clinic for Pediatric Surgery for at least 18 years in a co-ordinated team approach, 80 were selected on the basis of availability. Plaque control record (PCR), calculus index (CI), gingival bleeding index (GBI), pocket probing depth (PD), loss of attachment (LA) and furcation involvement were recorded. Using the technique and the ruler described by Schei et al., the radiographic height of the alveolar crest from the cemento-enamel junction was determined. Between the different groups of deformities, no statistically significant differences were found for all the clinical parameters with the exception of the mean PD orally and the mean PD bucally which were shallower in the isolated cleft lip group. These differences were attributed to the long-term orthodontic therapy with fixed appliances. When the PD and the LA at the sites adjacent to the cleft region were compared to two "unaffected" control sites, no statistically significant differences were found, whereas the comparison with the radiographic bone loss showed a statistically significant lower bone height. These results may indicate the presence of a long connective tissue attachment without bony support in the cleft region. As a result of inadequate oral hygiene, the patients with cleft lip, alveolus and palate showed beginning periodontitis with loss of attachment and beginning furcation involvement in most of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)