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Telemedicine has found its way into legislation through the so-called E-Health Act. It can serve as an aid in the provision or application of medical services by means of information and communication technologies, if patient and practitioner cannot be at the same location. The principle of orality must be observed. The extent to which this can create the relationship of trust necessary for informed consent must be weighed up. It must also be checked whether all the findings needed for proper informed consent are available. As a rule, a prior personal examination is therefore indispensable, as only in this way can the indication for the intervention as well as the anaesthetic and surgical suitability of the patient be determined with sufficient certainty. Standardised informed consent forms must be checked for their content and individualised for the specific case, in order to have a sound basis for discussion with the patient. Particularly, the risk-benefit ratio, costs, insurance cover, possible complications and, if applicable, risks of implant loss of the intended measure should be mentioned. The timing of the informed consent consultation depends on the urgency of the measure. In the case of measures that can be planned and are not acutely indicated, the timepoint must be chosen so that the patient still has the opportunity to consider and ask supplementary questions. If the practitioner has any doubt as to whether the patient understands the information presented during the telephone informed consent conversation, he must insist that it be repeated in a personal conversation.

Three-dimensional (3D) implant positioning is an important prognostic factor for anterior dental implants. Modern 3D imaging and implant treatment planning systems are available today for precise dental implant planning and placement. The transfer of implant position information to industrially manufactured templates for guided implant surgery has been possible for years now. What is new is the possibility of combining the datasets with the surface scan data of a diagnostic wax-up and setup for prosthetic-driven implant planning. Digital setups can also be used. This article describes and discusses the available options for digital implant planning and guided surgery.

Background: This study aims at investigating the prognostic significance of lymph node ratio (LNR) in a cohort of patients with oral squamous cell carcinomas (OSCC), treated with neoadjuvant radio-chemotherapy followed by radical surgery. Methods: The study included 171 treatment-naive patients with biopsy-proven primary OSCC, being reviewed retrospectively. All patients received a concomitant neoadjuvant radiochemotherapy (RCT) followed by radical surgery of the primary tumor and neck dissection based on the pretreatment staging results. The Kaplan-Meier survival analysis method was used to estimate the events of interest for overall survival (OS). Prognostic factors were identified through univariate and multivariate analysis. Results: The 5-year overall survival rate for all patients was 48 %. In univariate analysis, patient's age and data compiled from the histopathological examination as margin status, extracapsular spread, ypT, ypN, ypUICC, number of positive lymph nodes and lymph node ratio (LNR) had a statistically significant impact on overall survival. Multivariate analysis revealed an independent significant impact of patient age, ypT, margin status and LNR on OS. ypN showed no statistical significant impact on OS. Conclusion: Our results show that LNR is an important predictor for OS in patients with OSCC that were treated with neoadjuvant radiochemotherapy and radical surgery. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Background. The clinical relevance of implant malpositioning and avoidance of the complications are presented. Objective. The aim of this study was the development of strategies for avoidance of potential complications caused by incorrect positioning of implants. Methods and methods. A literature search was carried out in the Cochrane library and Medline database using the terms vertical positioning of dental implants, horizontal positioning of dental implants, inter-implant distances, tooth-to-implant distance, distances of dental implants and neighboring structures, implant failure, implants and biomechanical failure and distribution of implants. The studies identified were screened by reading the abstracts and irrelevant studies were excluded. All articles that were found to be potentially relevant were obtained in full text form. Results. Only a few randomized controlled trials were available on the subject. The results are discussed under the aspects of preimplantation risk assessment, three dimensional alignment of the implant, information on minimum distance from the granulation, implant angle and distance from neighboring structures.

The objectives were to assess the sinus anatomy and alveolar ridge dimensions and to identify clinical factors and morphological relationships that may predict the characteristics of the sinus anatomy. A total 336 edentulous molar and 168 edentulous premolar regions were analyzed. The mediolateral maxillary sinus (5 mm and 10 mm above alveolar bone), lateral maxillary sinus wall, ostium height, and alveolar ridges were measured. Measurement regions were defined by radiopaque simulation of the restoration goal. Mean molar mediolateral dimensions were >10 mm: first molar, 11.8 mm (range 3.8-21.1 mm); second molar, 12.2 mm (range 7.9-20.1 mm). The extent of the sinus differed significantly between premolars and molars (P < 0.001). The first molar region had the highest mean value for the lateral sinus wall (2.4 mm, range 0.2-7.9 mm) and the greatest distance between the alveolar crest and simulated restorative goal (8.1 mm, range 1.1-16.3 mm). Septum prevalence was 46% in the molar region and 27% in the premolar region. A lower alveolar ridge height was associated with a wider transverse extent of maxillary sinus and consequently longer distances between the crest and restorative goal. Systematic three-dimensional analysis of the maxillary sinus yields precise preoperative information about sinus configurations. There were significant variations and relationships among characteristics of the maxillary sinus, ridge, and the restorative goal.