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32. ICOSIM Weekly
1. Free ICOSIM Webinar on 21.02.24
2. New Publication: Is There a Question Deficit in Implantology?
3. “Do Not Miss” Dates 2024
Dear friends of ICOSIM and
jawbone osteoimmunology,
The new year 2024 starts with full power!
1. Free ICOSIM Webinar on 21.02.24
2. Next Article: Is There a Question Deficit in Implantology?
Who in implantology considers the “immunological sustainability” of invasive procedures? In this context, an implant significantly interacts with osteoimmunological processes related to jawbone quality, especially when it goes beyond simple drilling and post placement. Does it matter for the local quality of osseointegration whether the material is titanium or ceramic? Or does individual material hypersensitivity play a role in this?
These systemic-immunological questions about osseointegration and osteoimmunology, beyond peri-implantitis and mechanical BIC, are addressed for the first time in our latest PubMed-indexed study using radiation-free trans-alveolar ultrasound sonography (US) and precise bone density measurement (CTU) with US/CTU (comparable to Hounsfield units):
Lechner J, von Baehr V, Notter F, Schick F.
Osseointegration and Osteoimmunology in Implantology: Assessment of the Immune Sustainability of Dental Implants Using Advanced Sonographic Diagnostics: Research and Case Reports.
Journal of International Medical Research. 2024;52(1). doi:10.1177/03000605231224161
For a free download (beware, it’s a 28-page PDF!) and an introduction to scientific work with ultrasound sonography, visit www.cavitau.de.
Our ultrasound sonography provides the following overview:
- US/CTU measurements indicate reduced Bone-to-Implant Contact (BIC) and diminished osseointegration in Ti-Stim-positive collectives compared to Ti-Stim-negative collectives. Additionally, Ti-Stim-positive groups exhibit higher inflammation levels.
- CTU measurements reveal better osseointegration and an eightfold higher BIC for ceramic implants compared to titanium implants.
- Multiplex analyses of RANTES/CCL5 expression demonstrate approximately 20-fold increased cytokine expression around titanium implants with bone marrow defects.
For more information on osteoimmunology in dentistry and to join the International College of Maxillo-mandibular Osteoimmunology (ICOSIM e.V.), visit www.icosim.de.
3. “Do Not Miss” Dates 2024
a) Tissue Master Congress: CaviTAU and lecture: March 14-15 in Nuremberg
b) Not only the Bundeswehr, but also CaviTAU® in Lithuania!
c) Craving for Sunshine: Barcelona, April 2024
I have the occasion to lecture on the “XXI National Congress of Kinesiology”, which will be held at the Espai Pujades 350 in Barcelona on April 11, 12 and 13, 2024.
My presentations are scheduled for
Thursday, April 11 at 3:00 p.m. – 7:00 p.m. with the title “Pre-Congress Course: Integrative Oral Medicine and Osteoimmunology” and
Saturday , 12 april at 13.15 p.m – 13:45 pm with the title “Unattended systemic diseases of mandibular cause diagnosed by ultrasound”
Congress website: https://www.sekmo.es. Instagram link of my intervention planned https://www.instagram.com/p/C2ejmeyIdUu/
I remain with collegial greetings until the next ICOSIM Weekly.
Your Hans Lechner.
31. ICOSIM Weekly
1. New publication: Does X-ray lead dentists to the wrong pathology?
2. Call for multicenter study
Dear friends of ICOSIM and
jawbone osteoimmunology,
First of all, I wish you a Happy New Year 2024!
And I am also happy to announce some good news:
1. New article on CaviTAU® and RANTES/CCL5 with the central question
Does X-ray lead dentists to the wrong pathology?
In collaboration with the scientific institutes of the University of Lisbon/Dr. Joana Vasconcelos e Cruz, our Munich Research Team (Lecher/Notter/Schick) has presented another scientific publication in the PubMed-indexed Journal of Inflammation Research:
Comparison of cytokine RANTES/CCL5 inflammation in apical periodontitis and in jawbone cavitations – Retrospective clinical study
The central statements of your current publication are:
a) Even the apical granulomas/apical periodontitis visible in the X-ray express RANTES/CCL5.
b) However, the FDOK areas that are not detectable in the X-ray exhibit a 3x higher inflammation pattern of RANTES/CCL5.
c) The actual pathogenic chronic inflammatory triggers of the immune diseases caused by RANTES/CCL5 overexpression (such as rheumatism, cancer, neuroinflammation, etc.) are regularly not treated by dentists, as they are only detectable with ultrasound sonography using CaviTAU®.
d) Conclusion: The fixation on the X-ray image prevents the treatment of systemic immune diseases in dentistry; a complementary application of ultrasound sonography is necessary from an integrative medical perspective for patient protection.
The graphic shows the unequal distribution of RANTES/CCL5 expressions in pg/mL:
Here is the translation of your message to English: “An illustration of the 4 case reports shows the difference in radiological presentation of a chronically inflammatory bone marrow defect compared to the imaging of ultrasound sonography CaviTAU® and the RANTES/CCL5 overexpression of 3,928 pg/ml compared to the norm of 149.9 pg/ml.
Such articles in medical journals are of invaluable value to our practice success in distinguishing us from less advanced colleague practices!
2. Call for a multicenter study
For another multicenter study on the CCL5/CCR5 axis and breast cancer using the reference standard RANTES/CCL5 discovered by us, we are looking for colleagues who
a) perform FDOK with a RANTES/CCL5 multiplex analysis at IMD (following the example of Hans Lechner) for forensic control
and
b) perform these FDOK operations on patients with breast cancer
Is this applicable? Then please contact ICOSIM project leader Hans Lechner immediately!
I am looking forward to hearing opinions and questions from our ICOSIM colleagues and remain with collegial greetings until the next ICOSIM Weekly.
Your Hans Lechner.
30. ICOSIM Weekly
1. Newspaper article: successful treatment of trigeminal neuralgia, facial pain and Parkinson’s disease
2. Case of the week: Trigeminal neuralgia again despite Janetta surgery!
Dear friends of ICOSIM and
jawbone osteoimmunology,
1. Article about our successes with patients
I am pleased to be able to share a nice surprise with you: A great article has appeared in the Swedish newspaper TF-bladet about our successes with patients that we have been able to achieve with the help of CaviTAU®. The reference to the success of “Ultrasonography Guided Jawbone Detox” in the treatment of trigeminal neuralgia and facial pain and to a case of Parkinson’s disease that we cured with CaviTAU® and Jawbone Detox is journalistically perfectly presented!
Such articles in medical lay portals are of course invaluable for the success of our practice!
Here you can download the article as original in Swedish or as translated English version:
2. The case of the week: Trigeminal neuralgia despite “Janetta surgery” at the base of the skull
An approximately 55-year-old female patient presents to our practice clinic with trigeminal neuralgia in the upper right jaw. Her history is so interesting because after 15 years of constant neuralgia she found freedom from pain after a Janetta operation on the right. However, this only lasted for around 18 months, as she has now had the same trigeminal neuralgia again for 6 months. Our CaviTAU® image clearly shows why the pain in the upper right has returned: The osteoimmunologic inflammation in the alveolar bone OK right is still active!
Questions about the case:
a) Why do neurologists rush straight to Janetta surgery at the base of the skull instead of starting diagnosis and therapy at the peripheral nerves in the jaw area?
b) Should we then be surprised that the initial success of the Janetta operation disappears if the chronic inflammatory FDOJ irritation from the periphery persists?
c) Of course, a dentist has already offered to “pull the teeth” in the past: without correcting the osteoimmunologically dysregulated jawbones, this would only have led to a widespread negative assessment by the neurologist: “Just don’t pull teeth!”
I look forward to hearing opinions and questions from our circle of ICOSIM colleagues on this topic and remain with best wishes for the festive season and best regards from my colleagues until the next ICOSIM Weekly in the New Year 2024!
Your Hans Lechner.
29. ICOSIM Weekly
1. Excerpt from our scientific study in the Journal of International Medical Research
2. FDOK documentation with 69 images and histologies
Dear friends of ICOSIM and
jawbone osteoimmunology,
1. Journal of International Medical Research
In our last Weekly, we highlighted the fantastic opportunity to gain previously impossible insights into osteoimmunology with CaviTAU®. Here is an excerpt from our scientific study in the Journal of International Medical Research (PubMed indexed) on:
Osseointegration and osteoimmunology in implant dentistry: Evaluation of immunologic sustainability of dental implants using modern sonographic diagnostics.
Solid implant attachment, marginal mucositis and peri-implantitis are easy to evaluate diagnostically. However, this does not apply to osteoimmune processes in the hidden area of para-implant osseointegration. To our knowledge, we are the first to be able to prove the following on the basis of our data:
The problem: Bone marrow defects of the jaw (BMDJ) in the vicinity of dental implants in combination with impaired bone-to-implant contact (BIC) are difficult to detect on radiographs and have therefore been little studied.
So, using CaviTAU® and the CTU ultrasound measurement unit (see previous ICOSIM Weekly), we investigate BMDJ around titanium (Ti-Impl) and ceramic (Cer-Impl) implants and clarify the role of osteoimmunology in the development of incomplete BIC. Can the CaviTAU® ultrasound device accurately assess and compare the osseointegration of Ti-Impl and Cer-Impl with precise numerical scaling of BIC?
a) The previously neglected reduced bone-to-implant contact (BIC) and partially failed osseointegration can be detected by measuring the para-implant bone density with CaviTAU®.
b) CaviTAU®measurements for Cer-Impl CTU values are higher than those for Ti-Impl. Cer-Impl show significantly better long-term osseointegration compared to Ti-Impl.
c) The use of Cer-Impl instead of Ti-Impl does not generally exclude the possibility of impaired osseointegration.
d) For this reason, the evaluation of bone density and bone metabolism in the selected alveolar region should be performed prior to implantation with CaviTAU® regardless of the choice of implant material.
e) Implantation in osteoimmunologically unstressed alveolar bone assessed with CaviTAU® appears to be the key factor for successful osseointegration and long-term osteoimmune sustainability of dental implants.
f) Analysis of areas with incomplete BIC shows local overexpression of RANTES/CCL5, which may have systemic consequences and inflammatory disease[15].
The results of our combined diagnostic (Ti-Stim and CTU) and pathogenetic (RANTES/CCL5) findings support
1) the consistent use of Cer-Impl and
2) the pre- and post-implant metrological use of ultrasound sonography with CaviTAU® in dental implantology.
2. For all those who still do not believe in the existence of this pathology…
Book publication: FDOK documentation with 69 color images and histologies for online purchase:
I look forward to hearing opinions and questions from ICOSIM on this and I remain with collegial greetings until the next ICOSIM Weekly!
Your Hans Lechner.
28. ICOSIM Weekly
1. Scientific evidence: comparative BIC measurement of titanium to ceramic implants
2. The trick to BIC measurement
Dear friends of ICOSIM and
jawbone osteoimmunology,
1. How you secure the implantation success!
The biggest problem of modern implantology related to bone-implant contact is the insufficient stability of the implant after implantation. The stability of the implant depends on the quality of the bone and the size of the contact between the bone and the implant. Insufficient stability of the implant can cause the implant to move and form connective tissue instead of bone around the implant.
a) The problem: Quote from Prof. Albrektsson “However, no technique has yet been developed to visualize and verify whether bone or soft tissue is actually present around Implants.” [Albrektsson T, Chrcanovic B, JacobssonM, Wennerberg A.(2017) Osseointegration of Implants– A Biological and Clinical Overview. JSM Dent Surg 2(3): 1022.]
b) The solution: successful measurement of bone to implant contact (BIC). In our latest article published in the PubMed-indexed Journal of International Medical Research titled “Osseointegration and Osteoimmunology in Implantology: Assessment of the Immune Sustainability of Dental Implants using Advanced Sonographic Diagnostics – Research and Case Reports” by Johann Lechner1, Volker von Baehr2, Florian Notter3, Fabian Schick4, we were able to scientifically prove the comparative BIC measurement of titanium to ceramic implants.
c) Implementation: Currently, CaviTAU is still the only device on the market that can successfully and accurately perform such a BIC measurement. Scientifically proven and based on years of research results, we naturally also enable our ICOSIM members to access this methodology and application.
(Workshops here CTA)
d) The conclusion: Through the ultrasound sonography with CaviTAU®, a central diagnostic gap for success control in the entire dental implantology has now been closed!
2. The trick to BIC measurement: The new CT-Unit (CTU) in CaviTAU®, ultrasound analog to Hounsfield Unit HU in DVT.
To do this, use the CaviTAU® Viewer software (available for purchase in the CaviTAU® Shop). First, I’ll show you how to start the CaviTAU® Viewer software on your computer and then load the desired patient files into the viewer.
1. Load the desired patient files onto your laptop or PC.
2. Where can you find the original files you want to copy?
3. You can find the files on your MASTER-CaviTAU® device under the file path: E/Cavitau/and there the file with the patient’s name.
4. Right-click and copy the file to a USB stick.
5. Now plug the patient file on your PDF stick into your laptop or PC that works with your CaviTAU® Viewer software.
6. Set up a folder on your laptop or PC, for example “CTU calculations”, where you can save all your patient scans later.
7. Now click on the CaviTAU® Viewer software icon on your desktop.
8. Wait for the viewer to start.
9. Now you have to name the folder where the viewer finds your CTU patient files.
10. To do this, click on “Patient Scans” in the upper left corner, a new window opens with “Folder Settings” in the upper right corner.
11. Click on “Folder Settings” and select your folder “CTU Calculations” from the folder offerings.
12. Confirm with “Select Folder” at the bottom right.
13. Now close the viewer and restart the viewer.
14. After the restart, click again on “Patient Scans (left) above…and the window with your patient name opens immediately.
15. Click on this patient name and confirm with “Load-Scan File” (lights up green when confirmed with the mouse)
16. Your laptop/PC then loads all patient data onto your screen.
17. Now you can start interpreting. To do this, select the odonton you want to interpret or calculate…
18. To do this, select the most meaningful of the at least 3 prescribed scans.
19. Now click on “Cell Average” and “log” in the upper right corner.
20. Immediately below the large projection of the selected field, a field called “CTU Window” with “Selected Cell, and Average “log” opens up.
21. Now click on the darkest fields with the mouse.
22. You have the choice of the darkest red – left, darkest blue – right.
23. The clicked cells are marked with a white border.
24. Experience shows that at least 7-8 cells of the darkest color must be selected to create a reliable CTU value.
25. Now the CTU window shows you the CTU value: the lower the value, the lower the bone density. Now I will show you the interpretation or CTU calculation using a specific case example:
I look forward to hearing from you and remain until the next ICOSIM Weekly with collegial greetings!
Your Hans Lechner.
27. ICOSIM Weekly
1. Call for ICOSIM study
“Does the implant hold in the structure or not?”
2. Save the Date: 3. Tissue Master Congress
14.-16. March in Nürnberg
Dear friends of ICOSIM and
jawbone osteoimmunology,
1. Augmentat and Ultrasound Sonography:
Does the implant hold in the structure or not? – “Failed Implants” – Patient cases without success control
Patient 1: About 2 years ago, I had an implant from SDS with internal sinus lift inserted by a specialist who was recommended to me. After a healing period of 7.5 months, the implant began to wobble 2 weeks after the crown was placed, and the dentist removed it again. After the implant removal, I suffered from dizziness for several days. I have also had joint pain since then, which I never had before.
I am 58 years old and generally healthy, have good teeth (first dental prosthesis), and have a good immune system. According to my blood test, my D3 value (87 ng/ml) and other nutrients are very good. Therefore, it is unclear why the implant did not hold.
Building material: Bio-Gide membrane, Geistlich/Nano Bone mixed with autologous blood.
My response: The colleague works with his bone structures – like many other dentists – without knowing whether this artificial attempt has been successful, because he does not have a device to determine the bone density of his augmentation to such an extent that the inserted implants now hold or not. The X-ray image obviously does not allow this conclusion.
By using an ultrasound sonography with CaviTAU®, he could have checked and the implant would not have fallen out after being loaded (you are not alone in this; the internet is full of such complaints).
Patient 2: On Facebook a young patient reports:
Has anyone had multiple ceramic implants rejected? I had 3 placed in expensive healed bone grafting and all 3 have failed before 6 months. One failed right away and the other two lasted weeks before failure.
Question:
Is the grafting ready to hold the implants?
How to determine the bone density of grafting?
An ultrasound sonography with CaviTAU® might be the answer!
Call for ICOSIM study
The number of providers of bone replacement materials for the augmentation of reduced jaw conditions of various origins is increasing. This leads to increased statements by dental users and manufacturers about the success of the respective product, which is usually supported by local histological sections.
The success of an augmentation is consistently measured by the degree of ossification of the artificial augment. The success of implantation into the augmented replacement tissue depends on its osteoneogenic quality.However, it seems difficult to reliably determine the actual density ratios for dentists in practice with the X-ray methods available so far.
There is therefore both a diagnostic gap – simple measurement of bone density in the augment; and a therapeutic gap – the dentist cannot reliably determine a reliable time for implantation.
The aim of the study is therefore to measure the density of the augment using the medically approved and scientifically validated CaviTAU® ultrasound sonography procedure and thus obtain reliable statements about the degree of healing and implant readiness of the bone substitute. At the same time, a sample is taken and cytokine analysis of the augment takes place at the end stage of healing during implantation.
Sponsors of the study can be:
a) Dentists who want to check the clinical valence of their practice method for augmentation and want to present this to patients as a reference to their implantation expertise with scientific data material and publication.
b) Manufacturers of replacement materials who want to follow and present a retrospective course study of the healing degree of their product in cooperation with dentists they trust. They gain medically relevant statements about the quality of their product in comparison to the market offering.
If you are interested in participating, please contact me: drlechner@aol.com
2. Save the Date:
3. Tissue Master Congress “Innovative aspects for dento-alveolar therapy – tackling root diseases”
will take place from March 14-16, 2024 in Nürnberg
The event will feature a lecture by Hans Lechner on “Osteoimmunology and implant success – long-term immune sustainability of dental implants.”
You can download the flyer or visit the congress website for more information and registration details:
I look forward to seeing you in Nuremberg and remain with collegial greetings until the next ICOSIM Weekly.
Your Hans Lechner.