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Introduction: The aim of this project was to develop a standard food model, which can be used not only in experimental settings, but also in clinical diagnosis. On the basis of the findings of a systematic literature search, an elastic food model was created with the aim of standardizing the size and the elastic properties. Three different eatable jellied products were chosen, created by changing the amount of gelatin (260 blooms) related to the total mass of the standard jellied food. The different hardness were classified into soft, medium, and hard, flavored identically, but stained with different colors: soft -green, medium -yellow, hard -red. A cylindrical form was chosen, with a height of 1 cm and a diameter of 2 cm. A standard protocol for analyzing chewing patterns in men was developed.Material and method: A case series of 6 participants (three males, mean age 39, range from 17-51 years; three females, mean age 30, range 17-52) was performed, using the developed standard protocol as described in this article. CADIAX diagnostic was used for the recording of the chewing cycles using a standard paraocclusal clutch, individualized with self-curing temporary material. Working side and nonworking side chewing dynamics were recorded and analyzed. Adverse Event reporting was performed.Results: All participants correctly identified the different hardness of the new jellied elastic standard food model. All participants were able to perform a single-sided mastication on the right and on the left side as well as repeated shifts from one side to the other. The chewed and crushed jellies could be collected after the recording. The chewing cycles were performed in an adequate range because of the size of the standard food model.Conclusion: The newly developed standard food model showed the capability to serve to analyze human mastication in experimental settings. In addition, strength and size of the newly developed standard food model load the masticatory system to an extent that it should be possible to disclose subclinical symptoms of the patient within a short time of examination. The diagnostic procedure of temporo-mandibular disorder (TMD) should be endorsed by the new method. The condylographic data, created by a standardized protocol, should have the ability to enhance the clinical functional analysis of patients previous to restorative dental procedures.

EinleitungDurch Erhängen wurden neben Frakturen des 2. Halswirbels, welche bereits Bouvier (1843) u. a. beschrieben hatten, seither zahlreiche ligamentäre und ossäre HWS-Verletzungen verursacht [1,8,222,258,259]. Grogono (1954) [1] erkannte bei Verkehrsunfallopfern Ähnlichkeiten im Frakturmuster C2 mit jenen von Wood-Jones (1879 -1954 beschriebenen Frakturen der Erhängten, der bilateralen "fracture of the pedicle of the axis" [259]. In Analogie folgte die "Hangman's fracture" (Hmfx). Durch die diskoligamentäre Zerreißung im Segment C2/3 und die abgleitende Fraktur am Isthmus können mitunter groteske Dislokationen des Cervicocraniums, gelegentlich auch mit neurologischen Komplikationen, herbeigeführt werden [1]. Garber (1964) erkannte dieses Potenzial und wählte den treffenden Begriff "traumatische Spondylolisthesis C2/3" (TS C2-3 ).Aus Synopsis der Literatur lässt sich infolge kleiner Kollektivzahlen und inhomogenen Klassifikations-und Therapiekonzepten kein Konsens feststellen [1,8]. Der Diskussion sei an dieser Stelle vorweggenommen, dass funktionell stabile Läsionen mit intaktem diskoligamentären Apparat und instabile, vice versa mit diskoligamentärer Desintegration C2/3 unterschieden werden können. ZusammenfassungDie traumatische Spondylolisthesis C2/3 stellt eine potenziell diskoligamentär instabile Halswirbelsäulenverletzung dar. Konservative Therapiekonzepte führten in der Vergangenheit bei diesen Verletzungstypen mehrfach zu Therapieversagen und -wechsel auf operative Stabilisierung. Mit Erfahrung von über 20 Jahren in der operativen Therapie dieser instabilen Verletzungen stellen wir in unseren Langzeitergebnissen 34 vornehmlich durch ventrale Spondylodese C2/3 behandelte instabile traumatische Spondylolisthesen C2/3 vor. Mit Blick auf die durchwegs guten bis sehr guten Ergebnisse werden in einer ausführlichen Diskussion Empfehlungen zu Diagnostik, Klassifikation und Therapie vorgestellt. AbstractThe traumatic spondylolisthesis C2/3 presents a potential discoligamentous unstable cervical spine injury. In the past several times conservative treatment of unstable types of these fractures lead to failure or change of the attempted treatment. With experience of more than 20 years in the operative treatment of these unstable injuries we present our long-term results of 34 cases. In most cases anterior fusion C2/3 was performed. With a view of our entirely good to very good results we present our recommendations for diagnostic, classification and therapy in a comprehensive discussion.

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