Gutenberg Open Science

Das Open-Science-Repositorium der Johannes Gutenberg-Universität Mainz.

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ZeitschriftenaufsatzAccess status: Open Access ,
Technical and biological complications of implant-supported fixed complete dentures : a retrospective cohort study with up to 17 years of follow-up
(2026)
Pelser, Djan
;
Schepers, Markus
;
Abou-Ayash, Samir
;
Bjelopavlovic, Monika
;
Bremer, Mark K.
Purpose To retrospectively evaluate biological and technical complication rates of implant-supported fixed complete dentures (IFCDs) in edentulous jaws and to identify factors associated with complications over long-term follow-up. Methods Between 2003 and 2023, 91 IFCDs supported by 498 implants were placed in 72 patients. Mean observation period was 6.8 years (0.5–17). Biological and technical complications were compared between materials. Time until first complication was estimated using Kaplan–Meier analysis and risk factors for recurrent complications were assessed through multivariable Andersen–Gill Cox regression. Results Seven IFCDs failed, corresponding to a cumulative overall IFCD survival of 92.3%. Twenty-one of 498 implants (4.2%) were explanted. Overall prosthesis survival of resin veneered (RV) and ceramic veneered (CV) IFCDs did not differ (p = 0.85), whereas veneer fracture–free survival was significantly higher for CV IFCDs (p = 0.0094). In total, 169 complications were recorded, including recurrent events, whereas 49.5% of prostheses remained complication-free. Technical complications predominated, with veneer fractures representing the most frequent event. Biological complications such as peri-implantitis and implant loss occurred less frequently. Compared to base metal alloy–ceramic IFCDs, titanium–resin IFCDs exhibited a significantly higher overall complication risk (HR 4.25, p = 0.0015), particularly for veneer fractures (HR 7.11, p = 0.0029). Conclusions Within the limitations of this long-term retrospective cohort study, IFCDs demonstrated high prosthesis and implant survival rates, but a considerable number of predominantly technical complications. The choice of framework and veneering material appears to influence long-term complication risk and should be carefully considered during treatment planning.
ZeitschriftenaufsatzAccess status: Open Access ,
Why care resists coding : the moral limits of medical AI
(2026)
Wagner, Nils-Frederic
The growing integration of artificial intelligence (AI) into healthcare raises substantial normative questions about the nature of caregiving. While medical AI can improve clinical efficiency and assist with administrative tasks, I argue that patient-facing medical AI cannot straightforwardly substitute for genuine caregiving—understood as an embodied, relational, and morally responsive practice that remains answerable to patients’ vulnerability over time. Drawing on conceptual analysis and empirical evidence, I contend that caregiving exceeds technical competence, requiring context-sensitive responsiveness and a form of moral commitment that grounds responsibility when interpretation and response go wrong. Empirical studies on touch in clinical settings underscore how embodied reassurance and trust are mediated by consent, context, and relational meaning in ways current technological proxies only partially reproduce. Although medical AI may simulate elements of empathy through affective cues and conversational performance, such simulations risk generating interactions that appear supportive while obscuring the locus of responsibility within the care relationship. Hybrid AI-human care models and ‘ethics-by-design’ approaches, while often proposed as solutions, can diffuse accountability and fragment moral responsibility unless governance and clinical workflow design preserve clear human answerability. More critically, increasing reliance on patient-facing medical AI may not only yield inadequate simulations of care, but also contribute to a gradual redefinition of what caregiving entails. As expectations shift, relational responsiveness may be displaced by procedural adequacy as the prevailing standard.
ZeitschriftenaufsatzAccess status: Open Access ,
Hair cortisol concentrations to picture the dysregulation of the hypothalamic-pituitary-adrenocortical axis in panic disorder
(2026)
Petrowski, Katja
;
Renner, Vanessa
;
Herhaus, Benedict
;
Conrad, Rupert
;
Kirschbaum, Clemens
Panic attacks are characterized by intense feelings of uncontrollable threat and induce experiences of intense stress. As one of the major physiological stress systems of the body, the hypothalamic-pituitary-adrenocortical axis (HPA) may be a key to our understanding of a biological basis of this anxiety disorder. While recent studies have found evidence for short-term HPA changes in panic disorder with flattened cortisol responses to stimulation, no data have been available on tonic, i.e., long-term HPA activity in these patients. The current study therefore investigated the cumulative cortisol incorporation in hair over the period of three months in patients with panic disorder (n = 45) and healthy individuals (n = 45). Results showed higher hair cortisol concentration in patients with panic disorder compared to healthy controls. The duration and the severity of the disorder was unrelated to hair cortisol concentrations. In subsample analyses, patients with panic disorder and comorbid depression showed no significant differences in hair cortisol concentration compared to patients with pure panic disorder. The present findings do not support to the notion that a hypoactive HPA axis may be an important biological feature of patients suffering from panic disorder. Future studies will have to show in a large sample whether a changed HPA axis reactivity is present and causally related to the development and course of the disorder.