Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde
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- Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde (108)
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40-Year Longitudinal Caries Development in German Adolescents in the Light of New Caries Measures
(2019)
This study assessed the 40-year longitudinal caries development in German adolescents in the light of the sixth National Oral Health Survey in Children (NOHSC, 2016) employing initial DMFT (IDMFT), Significant Caries Index (SiC) and Specific Affected Caries Index (SaC). On the basis of the current NOHSC (randomized cluster selection using school list or regional community school surveys, 55,956 12-year-old sixth-graders examined by 482 calibrated community/study dentists) DMFT, SiC, a novel IDMFT including initial lesions (IT) and the recently introduced SaC were calculated and also recalculated for national and international surveys from the last 4 decades. In 2016, 78.8% of children were caries-free (DMFT = 0), 65.5% including IT lesions. The mean DMFT was 0.44 (single components: DT = 0.14, MT = 0.02, FT = 0.29, IT = 0.52) showing a clear association with the school type as marker for the socio-economic status. The mean number of affected teeth in children with DMFT >0 was 2.07 (SaC) in comparison to almost 9 teeth in the 1970s. The current care index on the tooth level was 66.3%, leaving only 7.7% of children with restorative treatment needs. Longitudinally, a continuous caries decline of more than 80%, including the risk groups (SiC/SaC), to an internationally extremely low level was observed. In conclusion, the National Oral Health Surveys reveal a continuous caries decline to a very low caries level in 12-year-old 6th-graders in Germany even if IT lesions are included (IDMFT). In spite of proportional reductions in the risk groups (SiC/SaC), the polarized caries distribution according to socio-economic parameters reveals the need for targeted preventive programmes.
Despite a plethora of therapeutic approaches, the injection of local anaesthetics itself remains one of the most painful and dreadful procedures among children. Stimulation of acupoint LI4 is associated with analgesic effects in dentistry. Goal of the study To investigate whether stimulation of LI4, added to standard therapy (ST), reduces pain and distress during injection of local anaesthetic (LA) in comparison with ST alone. Materials and Methods Children, scheduled for dental treatment in local anaesthesia on 2 separate days were enrolled in this trial, approved by local ethics commission. On one day each child received bilateral acupuncture of LI4 point, using indwelling fixed “New Pyonex” needles (0.2 x 1.5 mm; Seirin, Japan). The parents of the children were asked to stimulate the needles by massage. Standardized injection of LA was performed 5 min following acupuncture. The needles were withdrawn at the end of dental treatment. On the other day of treatment children received LA injection without acupuncture. The order of treatment days (acupuncture first or vice versa) was randomised. Primary endpoint was the pain intensity during LA injection reported by children on Visual Rating Scale from 0=no pain to 10=maximal pain imaginable (VRS-11). Secondary endpoints were parent- and dentist-assessed pain intensity (measured on Numeric Rating Scale 1-10), patients’ heart rate before and during dental treatment and satisfaction with received therapy (measured on Numerical Rating Scale 1-5.) Side effects of LI4 stimulation were also recorded. Results and Discussion The data of 49 children (22 females; age 10 ± 4 yrs; mean ± SD), who completed both visits, were analysed. Children reported less pain with than without acupuncture: 2.2 ± 2.5 vs. 3.9 ± 2.7; mean ± SD, p<0.001. Heart rate decreased after LI4 stimulation compared to ST alone throughout the dental treatment (p<0.05). LI4 stimulation was safe and raised better satisfaction with the treatment among children and parents, than ST alone (p<0.05). Other secondary endpoints were comparable between both sessions. Conclusion Stimulation of acupuncture point LI4 reduces pain and autonomous stress during injection of local anaesthetics in paediatric dentistry.
Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458).
Objectives:
This study investigates the effectiveness of the Cold AP on the alteration of the enamel surface
without using acid etchant by using Conventional photo-activated resin bond to bond the
orthodontic brackets.
Materials and Methods:
One hundred and twenty-five Enamel specimens are prepared from disinfected bovine
mandibular incisors are divided into five groups. Group I: brackets are attached on the enamel
surface with the standard adhesive technique (etch + primer +bond). Group II: the brackets are
attached with the Standard Orthodontic adhesive technique without etching. Group III: the
enamel surface is conditioned with pure Argon Cold atmospheric plasma before the application
of the primer without using an acid etchant. Group IV: the enamel surface is conditioned with
the admixture of Argon Cold atmospheric plasma with 0.5 % Oxygen before the application of
the primer without using acid etchant Group V: after the application of Argon Cold atmospheric
plasma with 0.5 % Oxygen the surface is rewetted by deionized water before the application
of the primer and adhesive. After that, the samples are exposed to thermal cycling. The shear
bond strength of the samples is tested by the universal testing machine which measured the
maximum force at which the brackets are deboned from the tooth surface at a speed of
1mm/minute is measured.
Results:
Significant intergroup differences were found. Group V showed the highest shear bond
strength followed by Group I, VI, III, II respectively. There isn’t a statistical difference in the
values of The Shear bond strength values between Group III and IV.
Conclusions:
this study implies that Cold Atmospheric Plasma is a safe method to change the chemical
surface characteristics of the enamel surface.in addition to the significant importance of plasma
treatment followed by water rewetting, which could enhance adhesion between the orthodontic
attachments and the enamel layer
Hintergrund: Parallel zum generellen Kariesrückgang ist es zu einer Zunahme von ECC und Narkosesanierungen gekommen. Material: In der Greifswalder Zahnklinik wurden Überweisungen, Narkosesanierungen und Schmerzpatienten im Bereich der Kinderzahnheilkunde untersucht. Ergebnisse: Der Schwerpunkt liegt in allen Bereichen in der Altersgruppe 2-5-jähriger mit sehr hohen dmft-Werten. Diskussion: Die Studie unterstreicht die Polarisierung der Karies und die Notwendigkeit spezialisierter Kinderzahnheilkunde.
(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted.
Die Volkskrankheiten Diabetes mellitus und Karies setzten wir unter Verwendung der Daten der großen populationsbasierten SHIP-Studie in Beziehung, um die Hypothese zu bekräftigen, dass Diabetes mellitus Auswirkungen auf Koronalkaries hat. Durch SHIP-0, -1 und -2 war es uns möglich, Daten über einen Zeitraum von insgesamt 15 Jahren (1997-2012) zu verwenden, bei der in der Baseline-Studie 3731 Personen teilnahmen. Dies ist die erste Longitudinalstudie mit einem großen Stichprobenumfang, die eine mögliche Assoziation zwischen Diabetes mellitus sowie der metabolischen Kontrolle und der Koronalkaries untersucht hat.
Die Koronalkarieserfahrung wurde mittels DMFS-Index und deren Komponenten bei den Teilnehmern im Kiefer halbseitig ermittelt. Ein Typ-2-Diabetiker wurde definiert, wenn er eine ärztliche Diagnose angegeben hatte oder blutzuckersenkende Medikamente einnahm oder einen HbA1c-Wert ≥ 6,5% hatte oder einen Gelegenheits-Blutglukosespiegel von ≥ 11,1 hatte. Die Teilnehmer wurden in drei Gruppen eingeteilt: kein Diabetes mellitus, gut eingestellter Typ‑2-Diabetes (HbA1c 6,5%-7%) und schlecht eingestellter Typ-2-Diabetes (HbA1c > 7%). Die Daten wurden mit voll adjustierten linearen gemischten Modellen ausgewertet.
Die Ergebnisse unserer populationsbasierten 11-jährigen Longitudinalstudie wiesen auf eine HbA1c-abhängige Assoziation zwischen Diabetes mellitus und der Koronalkarieserfahrung hin. Ein schlecht eingestellter Diabetiker wies eine höhere DMFS-Langzeitprogression (0,761 Flächen pro Jahr) auf als ein gut eingestellter Diabetiker (0,473 Flächen pro Jahr) oder ein Teilnehmer ohne Diabetes mellitus (0,480 Flächen pro Jahr). Ein gut eingestellter Diabetiker hatte zudem die geringste DFS-Langzeitprogression (0,259 Flächen pro Jahr) gegenüber eines schlecht eingestellten Diabetikers (0,426 Flächen pro Jahr) und auch gegenüber eines Teilnehmers ohne Diabetes mellitus (0,337 Flächen pro Jahr).
Die Ergebnisse unserer Studie zeigten, dass die Koronalkarieserfahrung bei schlecht eingestellten Diabetikern größer war als bei gut eingestellten oder bei Teilnehmern ohne Diabetes mellitus. Dieses Kernergebnis unserer Studie ist möglicherweise durch die Veränderungen des Speichels, den höheren Glukosegehalt in der Zahnfleischtasche und eine anzunehmende mangelnde Mundhygiene eines schlecht eingestellten Diabetikers, beziehungsweise durch eine gute Compliance, anzunehmende gesündere Lebensweise und damit bessere Mundhygiene eines gut eingestellten Diabetikers zu erklären.
Langfristig sind große epidemiologische Langzeitstudien anzustreben, die die Beeinflussung zwischen Diabetes mellitus und Karies abhängig von HbA1c analysieren und somit Patienten mit einem gut oder mit einem schlecht eingestellten Diabetes mellitus differenziert betrachten. Um den möglichen kausalen Zusammenhang von der Diabetes geförderten Koronalkariesentstehung zu beleuchten, ist eine Analyse der Parameter Glukosegehalt, pH-Wert und Mikroorganismen im Speichel bei der Untersuchung von Teilnehmern in zukünftigen Studien zusätzlich zielführend.
Unsere Studie stellt den Anfang für weitere umfassende epidemiologische Studien dar, um zukünftig Patienten über die beiden Volkskrankheiten Diabetes mellitus und Karies aufklären und auf eine mögliche Assoziation von Diabetes mellitus auf Koronalkaries zum Schutz vor Folgeerkrankungen hinweisen zu können.
Einführung: Im Gegensatz zu den deutlichen Erfolgen bei der Kariesprävention in der permanenten Dentition von Kindern und Jugendlichen ist die Situation im Milchgebiss, und hier insbesondere der Sanierungsgrad, unbefriedigend. Ziel: Barrieren bei der restaurativen Therapie im Milchgebiss zu analysieren. Methoden: In einer randomisierten Querschnittsstudie wurde eine repräsentative Stichprobe aus dem Zahnärzteregister in Deutschland gezogen (n = 320) und ein Fragebogen zum Zahnärzteprofil (Geschlecht, Berufsjahre etc.), zur Beurteilung des zahnärztlichen Gesundheitssystems und von möglichen Barrieren bei der Sanierung im Milchgebiss (Kind, Eltern, Zahnarzt, Gesundheitssystem) versendet. Die Antwortrate von 57,7 % ließ valide und repräsentative Aussagen zu. Ergebnisse: Die Analyse zeigte, dass die Eltern einer restaurativen Therapie nicht im Wege stehen und auch die Zahnärzte sie für notwendig halten. Dagegen stellten die Angst der Kinder und ihre Abneigung gegen den Zahnarztstuhl oder Bohrergeräusche aus Sicht der Zahnärzte eine deutliche Barriere dar. Außerdem war die Mehrheit der Zahnärzte ausgesprochen unzufrieden mit der Betonung von restaurativen Leistungen im Gesundheitssystem und der inadäquaten Honorierung von Füllungsleistungen beim Kind. Neben einer geschlechtspezifischen Analyse bot sich bei der Auswertung der Daten ein West-Ost-Vergleich an, da ein hoher Prozentsatz der Zahnärzte vor der deutschen Wiedervereinigung nach unterschiedlichen Studienplänen in der Kinderzahnheilkunde unterrichtet wurde. Eine Selbsteinschätzung über die Einstellung der Zahnärzte, Kinderbehandlung anzubieten, zeigte für Westdeutschland größere Barrieren. Nur 36 % der ostdeutschen Zahnärzte fanden die Füllungstherapie bei Kindern zwischen 3 und 6 Jahren stressig, im Vergleich zur deutlichen Mehrheit in Westdeutschland (62 %). Schlussfolgerung: Die Ergebnisse deuten darauf hin, dass diese Unterschiede nicht zufällig sind. Die Herangehensweise, Kinder zu behandeln, wird vor allem durch die Ausbildung im Fach Kinderzahnheilkunde während des Studiums bestimmt, denn zu diesem Zeitpunkt wird die entscheidende Kompetenz zur Behandlung von Milchzähnen erworben.
Ziel der Untersuchung ist der objektive Nachweis emotionellen Stresses und seines Verlaufs während einer konservierenden Zahnbehandlung. Teilergebnisse werden mit 2 gleichgelagerten Studien verglichen. Es werden für 74 Probanden, durch vom Institut für Stressforschung in Berlin entwickelte Voruntersuchungen, individuelle Parameter für den Umgang mit Stress festgelegt. In der nachfolgenden Zahnbehandlung erfolgen die Messung der Zahnfleischtaschen, die Zahnsteinentfernung mittels zweier verschiedener Instrumente (Schall bzw. Ultraschall), ein Sensibilitätstest und eine Politur. Während der gesamten Behandlungszeit werden kontinuierlich Blutdruck, Muskelaktivität (EMG) und Hautwiderstand gemessen. Zur Auswertung werden Korrelationskoeffizienten zwischen den Datenreihen bestimmt, um die Synchronisation dieser Parameter über den gesamten Verlauf zu prüfen. Es zeigt sich, dass positiver Zuspruch, Motivation und Anleitung durch den Behandler einfache und effektive Möglichkeiten sind, um eine Entspannung der Patienten zu ermöglichen. Verschiedene Stressregulationstypen haben starken Einfluss auf das Verhalten der Patienten während der Behandlung. Die meisten Patienten zeigen bereits vor Behandlungsbeginn eine hohe Anspannung, die trotz mehrfacher Pausen zwischen den verschiedenen Behandlungsphasen und einem, nach eigenen Angaben der Probanden, nahezu schmerzlosen Prozedere, im Laufe der Behandlung weiter ansteigt. Die typische klinische Umgebung beeinflusst das Wohlbefinden der Patienten stark. Schlussfolgerungen zur Optimierung einer ganzheitlichen Behandlungsweise und zur Verbesserung des Arzt-Patienten-Verhältnisses sind möglich.
Die Arbeit stellt mit den Gesundheitssystemen der Bundesrepublik Deutschland, des Königreich Schweden und der Republik Estland drei europäische Gesundheitssysteme mit ihren zivilen und militärischen Anteilen vor, die sich im jeweiligen nationalen Konsens unterschiedlich entwickelt haben. Anhand der Analyse der Gesundheitssysteme werden zum einen verschiedene Wege zur Gewährleistung der Gesundheitsversorgung der Bevölkerung durch das zivile Gesundheitssystem und zum anderen auch die sanitätsdienstlichen Komponenten der Streitkräfte zur Gesundheitsversorgung der Soldaten aufgezeigt. Im militärischen Bereich des Gesundheitswesens werden sowohl die Aspekte der Versorgung im Heimatland als auch im Auslandseinsatz dargestellt. Kernfrage der Arbeit ist, ob sich aus dem Vergleich aller drei Systeme trotz unterschiedlicher Entwicklung Anstöße für die Weiterentwicklung des Sanitätsdienstes der Bundeswehr, insbesondere im Bezug auf zivil/militärische Kooperationsmöglichkeiten und/oder –notwendigkeiten sowie Synergieeffekte, ergeben.
This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with ‘caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in ‘healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors.
Background: Despite of the remarkable caries reduction in permanent dentition, caries levels of primary teeth has stagnated in Germany. Early Childhood Caries (ECC) or also known as baby bottle tooth decay is the most vulnerable form of caries in young children, but minimal data and information from different German states are available to determine the appropriate preventive programs. Aim: The purpose of the current study is to find the prevalence of ECC among young children in the state of Mecklenburg-Vorpommern (North-East Germany) and to optimize an intervention on ECC prevention in a community setting. In addition to education, fluoride varnish is evaluated on young children with active ECC. Design: In this cross-sectional study, a total of 4283 children living in the state of Mecklenburg-Vorpommern were examined. Four age groups - with an accuracy of one day - were formed as follows: less than one year (n=8), one year (n=293), two years (n=1618) and three years (n=1888). The examination was carried out by community dental service’s examiners whom are calibrated to ECC diagnostic criteria of Robke and Buitkamp (2002), and dmf-t values for caries diagnosis. These data are compared by those of children (n=5355) of same age group for the year 2011-2012. In addition, a structured questionnaire on the starting preventive programme on ECC was filled out by the community dentists and for the city of Greifswald, fluoride varnish (Duraphat®, 5% NaF = 2.26%F, Colgate-Palmolive, Germany) was applied for 32 children previously diagnosed with active ECC (ECC1: n=15, ECC2: n=17). Lesions are identified as active or non active according to texture and luminosity, and oral hygiene index (OHI-S) is measured and re-evaluated at three months follow up. Results: The percentage of children under three years old in 2012-2013 with ECC was comparatively low (4%) which possibly reflects the very young age of the children and a restriction for ECC on the upper incisors. The overall caries prevalence in Mecklenburg-Vorpommern varied from 9% to 15%. Most cavitated lesions are untreated. These results are comparable with the results from other German counties. The interventions of the ECC programme vary considerably among the different counties. There was no significant difference in the oral hygiene index (OHI-S) prior and post fluoride varnish application (p-value = 0.25). The use of fluoride varnish resulted in an 81%, statistically significant decrease of active ECC lesions in Greifswald (p < 0.001). Conclusion: The prevalence of caries among young children was considerable in Mecklenburg-Vorpommern. A preventive intervention in nurseries and fluoride varnish applications for active ECC lesions seems to be a feasible approach in controlling caries in early childhood. However, further quality management and standardization of the program should be reinforced.
Long-term nationally representative caries data in the primary dentition are rare, but nonetheless central to assess needs in caries prevention and treatment. This study evaluated the prevalence and trends of caries levels in the primary dentition of 6- to 7-year-olds in Germany as a whole and its federal states individually. In 2016, employing a randomized cluster selection, 6- to 7-year-old first graders were included in the National German Oral Health Survey performed regularly since 1994/95. Children were examined by 482 calibrated dentists in all 17 German regions using the WHO criteria for the decayed, missing, and filled teeth (dmft) including the assessment of initial carious lesions (it). In total, 151,555 6- to 7-year-olds were examined. Caries prevalence in the primary dentition dropped from 65% in 1994 to 44% in 2016, while the mean caries experience dropped from 2.89 to 1.73 dmft (dt = 0.74, mt = 0.19, ft = 0.80). When initial lesions were included, the mean caries experience increased to idmft = 2.12 (it = 0.38). In 2016, 49.7% of the examined 6- to 7-year-olds were caries-free including initial lesions. The Care Index at the tooth level was 57.5%, and the Significant Caries Index was 4.84 dmft. Depending on the German region, the mean dmft varied considerably, ranging from 1.37 to 2.31. In conclusion, despite the overall caries decline in 6- to 7-year-olds in Germany, only minor caries reductions were observed over the last decade, with a still existing high proportion of untreated dental decay. This calls for more effective preventive and restorative efforts with focus on the primary dentition in Germany.
Bei der regenerativen Medizin handelt es sich um die Bildung von lebendem und funktionalem Gewebe für Reparatur- oder Austauschprozesse von Geweben und Organen, welche durch Alter, Krankheiten, Zerstörung oder angeborene Defekte verloren gegangen sind. Die regenerative Medizin wird in der Zahnheilkunde vielseitig eingesetzt, so unter anderem durch Verwendung von Knochenersatzmaterialien. Diese können sowohl die Bildung von Knochen wie auch die Bildung von Weichgeweben, z. B. Muskelgewebe beeinflussen. Ziel der vorliegenden Arbeit war es, die Interaktion des ektopen Knochenersatzmaterials Poly-3-hydroxybutyrat (PHB) mit dem umgebenden Weichgewebe zu untersuchen. Dazu wurde der Einfluss von PHB auf die Transkription der Wachstumsfaktoren: IGF1, IGF2, GDF-8 and VEGF im Muskelgewebe analysiert. Für unsere Studie wurde synthetisch hergestelltes PHB benutzt in Form einer Scheibe mit einem Durchmesser von 12 mm und einer Höhe von 1,2 mm. Insgesamt wurden 20 männliche Wistar-King Ratten verwendet, von denen 12 mit PHB behandelt wurden und acht als Kontrollen dienten. Alle Tiere erhielten einen Schnitt oberhalb des Musculus lattisimus dorsi. Dabei entstand eine Tasche, in die das PHB implantiert wurde. Nach 6 bzw. 12 Wochen wurde das Muskelgewebe unterhalb des PHB´s entnommen und molekularbiologisch analysiert. Auf RNA Ebene wurde sowohl IGF1 wie auch IGF2, VEGF und GDF8 im Skelettmuskel der Ratte nachgewiesen. Dabei zeigte IGF1 die stärkste Expression, gefolgt von IGF2 und mit geringster mRNA Menge VEGF und GDF8. Nach PHB Implantation stieg die Genexpression von IGF1, IGF2 und VEGF im Muskelgewebe signifikant an. Im Gegensatz dazu wurde die mRNA Expression von Myostatin signifikant verringert. Es konnten keine zeitabhängigen Unterschiede detektiert werden. Aus diesen Ergebnissen lässt sich schlussfolgern, dass PHB mit dem umgebenden Muskelgewebe interagiert und einen Einfluss auf Wachstumsfaktoren besitzt, die die Vaskularisierung und die Muskeladaptation steuern. Außerdem konnte die gute Biokompatibilität von PHB makroskopisch nachgewiesen werden und die bereits erwobenen Informationen bezüglich der niedrigen Toxizität und guten Resorbierbarkeit bei Verwendung von PHB bei Knochendefekten ergänzt werden.
Until now proximal caries is still a significant problem in the clinical dentistry in spite of the caries decline recently. As resin infiltration offers a new micro-invasive treatment to arrest the progression of proximal initial carious lesions, this study aimed to evaluate its clinical applicability, safety and effect. In the study population of 50 children, adolescents and young adults (mean age 17.9 years ± 6.8), ten dentists at University of Greifswald applied the infiltration material ICON® (DMG, Germany) on non-cavitated proximal lesions in permanent and primary teeth as described in the manual instructions from the producer. The results showed good patient satisfaction with the procedure. The time for the infiltration (24.3 min ± 7.4), which included rubber dam application (7.7 min ± 4), and the effort were perceived as comparable to a composite filling by the dentist or as even easier. In three patients (6%), it was not possible to gain sufficient proximal space for the application of an infiltration. The location of the infiltrated tooth, separation problems as well as the routine of the dentists with the infiltration technique had an effect on the duration of the infiltration. A clear learning curve with a reduction of treatment time for subsequent treatments was observed (P < 0.001). Within the follow-up interval of 12 months, vitality of all infiltrated teeth was still positive and no relevant differences in plaque accumulation or gingival status were recorded. In addition, the infiltrated surfaces showed smooth margins and considerable decrease in the discoloration. In the radiographic evaluation after one year, only two lesions (4.7%) have progressed. Thus, caries infiltration is an applicable method for the treatment of initial non-cavitated proximal lesions without prior temporary tooth separation. Even without special training it can be applied easily by dentist and they experience a clear learning curve within the first 5-10 applications. In addition, the infiltration technique shows a high acceptance by the patients. Furthermore, caries infiltration lead to very good results regarding safety and preventing the lesion progression of non-cavitated proximal caries lesions located in the enamel or in the outer third of dentin.
We presented the prevalence of MIH in Dubai/UAE for the first time, which represents a developed Middle Eastern city and compared it to results obtained from Greifswald/Germany, which represents a developed European city. The results have shown that the prevalence of MIH in Dubai/UAE is higher than Greifswald/Germany. However, in comparison to the literature, the prevalence of MIH in Dubai is lower than other Middle Eastern cities. Furthermore, we have shown that there is a higher caries level associated with MIH in Dubai. This is also true in Greifswald, Germany and other international studies. In addition, we have reported the prevalence of caries and fluorosis in Dubai and compared them to Greifswald and the previous studies in Dubai. Nevertheless, caries values presented in this study and previous studies indicate that strong attention is required from health authority to this topic. This research provides a strong and comparable source of information on the prevalence of MIH in Dubai for other studies, since it followed strictly all methodological and clinical standards suggested for the assessment and diagnosis of MIH, which are the EAPD criteria. The findings presented in this study require particular attention from the local health authorities and general practitioners for such developmental defect to facilitate early and adequate diagnosis and treatment. This could be achieved by implementing continuing education courses on MIH detection, diagnosis, and treatment for general practitioners. Furthermore, this study has the potential to trigger new studies that would help in understanding the MIH etiology.
In fixed orthodontic treatments debonding of brackets during treatment is an unpleasant occurrence for the clinician and the patients and resultes in an increase in treatment costs and duration. For Damon Q brackets recycling would considered as an economic saving option which could be done with using of in office methods such as the sandblasting.
A sample of sixty sound bovine first upper central incisers, were collected, cleaned, and mounted in acrylic blocks for shear bond strength testing.
The total sample was equally divided into two main groups. Each group had 30 teeth and 30 brackets.
The first group had 30 teeth bonded with metal Damon Q brackets, the second group had 30 teeth bonded with metal Mini-Mono® brackets.The study included bonding and rebonding experiments. Therefore the same brackets with their same teeth were used in bonding and in the rebonding experiments. The bonding and the rebonding procedures were done with using 3M Unitek etching, Grengloo adhasive, and Ortho solo bonding. In addition the rebonding procedure was done after cleaning the teeth and recycling their brackets with sandblasting. All specimens were recycled 5000 times for the bonding and rebonding experiments.
The first and second debonding forces were done in Newton using a Zwick Roell machine.
After that SBS and SRS were computed in MPa. Furthermore all the teeth, after each debonding, were examined under a digital scanning microscope VHX-5000, 50X magnifying, to performe the ARA and ARI.
The collected data was statistically analyzed for descriptive statistics as well as significance of differences among the different bracket types, and their ARI scores, in the bonding and rebonding experiments.
The results showed that SRS was significantly higher than SBS of both types of the brackets, and Damon Q brackets had higher SBS, and SRS than Mini-Mono® brackets, and there was no correlation between SBS, SRS and their ARI, ARA.
40 Männer und 40 Frauen wurden untersucht, um zu überprüfen ob der steigende Schweregrad einer Parodotopathie die enzymatische Aktivität von Prokallikrein und Kallikrein im Mischspeichel beeinflußt. 10 Männer und 10 Frauen pro Gruppe: A:Gesund, B:Parodotopathie+, C:Parodotopathie++, D:Recall Eine signifikante Erhöhung der Enzymaktivität war lediglich bei Frauen der Gruppe B und Männern der Gruppe C zu verzeichnen.
The aim of this study has twofold. First, to investigate characteristics of paediatric patients seeking emergency dental care and the according treatment in a specialised dental service. The second aim, to propose a data-based guidance for management of dental emergency in children including pain management without traumatizing the child and with a clear differentiation of dental emergency patients.
Records of the demographic and clinical characteristics of 332 children (mean age 8.2 ±4.2 years) who attended the Department of Preventive and Paediatric Dentistry at the University of Greifswald in 2018 without an appointment seeking emergency dental care were collected. Statistical analysis was carried out using descriptive statistics and Chi-square tests. Based on the data a proposal for management of emergency/pain patients was performed.
Pain patients were high caries risk children (mean: 4.59 ±3.65 dmft, 1.65 ±2.73 DMFT). The main clinical diagnoses of pain patients in all different age groups were dental caries and caries-related complications such as reversible and irreversible pulpitis or periapical periodontitis (63.6%), while dental trauma contributed (8.4%). In general, the most frequent treatment was extraction (41.0%), most of these extractions needed to be rendered under either nitrous oxide sedation or general anaesthesia (57.3%).
This study has shown a clear association between the dental emergency management plan (delay of the dental treatment) and other factors such as, the required treatment (invasive or not invasive) P < 0.05, the need of sedation P < 0.05 and child’s previous dental experience (first visit to the dental clinic) P < 0.001. Most of the extraction procedures were not rendered immediately in the emergency/pain visit, rather they were delayed to be performed in the next treatment session (70%), with the majority of these procedures planned to be rendered under sedation. On the other hand, most of the restorations (65.5%) were performed in the emergency/pain visit, with need of sedation for only (8.3%) of these procedures. In addition, the majority of treatments of children who were visiting the dental clinic for the first time were postponed (71.6%; n=63). The correlation analysis shows a higher tendency to postpone the treatment when the required treatment is invasive, need to be rendered under sedation or when
it was the child’s first visit to the dental clinic. These findings indicate the strong impact of child’s cooperation on the emergency management plan.
Based on these data the guidance for management of peadiatric dental emergency patients was developed including pain management without causing negative affect of the child’s future cooperation